Path Grand Rounds: Intraductal Proliferative Lesions of the Breast: The Past, The Present, and The Future
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Mark Kilgore, MD
Acting Assistant Professor
Department of Pathology
University of Washington
Intraductal proliferative lesions of the breast are at times challenging to interpret for both experienced general pathologists as well as expert breast pathologists. This is especially true with borderline lesions, where the differential includes atypical ductal hyperplasia (ADH) and low-grade ductal carcinoma in-situ (DCIS). Even when a conclusive diagnosis of DCIS has been rendered, physicians continue to search for clues to determine the likely outcome in a given patient. While pathologists deal with the challenges associated with differentiating these diagnoses, clinicians are faced with deciding which patients are likely to have recurrence of DCIS and/or progression to invasive carcinoma, and therefore how aggressively to treat. Come listen to an overview of these lesions and how they have been handled in the past, as well as some current and future techniques that may help pathologists and clinicians deal with this challenging aspect of breast pathology.
After viewing this lecture, attendees should be able to:
1. Understand the subtleties and morphologic overlap of low-grade intraductal proliferative lesions of the breast (atypical ductal hyperplasia and low-grade ductal carcinoma in-situ).
2. Understand some of the immunohistochemical and molecular approaches researchers and clinicians are using to better define ductal carcinoma in-situ in terms of diagnosis and prognosis.
3. Understand the future of intraductal proliferative lesions of the breast and how we can better train pathologists to interpret them (especially using novel techniques, such as NDER).