Grade of recurrent in situ and invasive carcinoma following treatment of pure ductal carcinoma in situ of the breast R R Millis1, S E Pinder2, K Ryder3, R Howitt4 and S R Lakhani5 1Hedley Atkins Cancer Research UK Breast Pathology Laboratory, Guy's Hospital, London SE1 9RT, UK 2Department of Histopathology, University of Nottingham, Nottingham City Hospital, Hucknal Road, Nottingham NG5 1PB, UK 3Academic Oncology Unit, Guy's Hospital, London SE1 9RT, UK 4Department of Cellular Pathology, Southampton General Hospital, Southampton SO16 6YD, UK 5The Breakthrough Toby Robins Breast Cancer Research Centre, ICR and the Royal Marsden Hospital, London SW3 6JB, UK Correspondence to: Dr SE Pinder, E-mail: sarah.pinder@nottingham.ac.uk The grade of recurrent in situ and invasive carcinoma occurring after treatment of pure ductal carcinoma in situ (DCIS) has been compared with the grade of the original DCIS in 122 patients from four different centres (The Royal Marsden Hospitals, London and Sutton, 57 patients; Guy's Hospital, London, 19 patients; Nottingham City Hospital, 31 patients and The Royal Liverpool Hospital, 15 patients). The recurrent carcinoma was pure DCIS in 70 women (57%) and in 52 women (43%) invasive carcinoma was present, which was associated with an in situ element in 43. In all, 19 patients developed a second recurrence (pure DCIS in 11 and invasive with or without an in situ element in eight). The majority of invasive carcinomas followed high-grade DCIS. There was strong agreement between the grade of the original DCIS and that of the recurrent DCIS (=0.679), which was the same in 95 of 113 patients (84%). The grade of the original DCIS showed only fair agreement with the grade of recurrent invasive carcinoma (=0.241), although agreement was stronger with the pleomorphism score of the recurrent carcinoma (=0.396). There was moderate agreement, in recurrent invasive lesions, between the grade of the DCIS and that of the associated invasive element (=0.515). Other features that showed moderate or strong agreement between the original and recurrent DCIS were necrosis and periductal inflammation. The similarity between the histological findings of the original and subsequent DCIS is consistent with the concept that recurrent lesions represent regrowth of residual carcinoma. In addition, although agreement between the grade of the original DCIS and that of any subsequent invasive carcinoma was only fair, there is no suggestion that low-grade DCIS lesions progress to higher grade lesions or to the development of higher grade invasive carcinoma. This is in agreement with immunohistochemical and molecular data indicating that low-grade and high-grade mammary carcinomas are quite different lesions. British Journal of Cancer (2004) 90, 1538-1542. doi:10.1038/sj.bjc.6601704 Published online 30 March 2004 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.