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Invasive breast carcinoma with a DCIS-like growth pattern: Clinicopathological features and diagnostic pitfalls
Xiaoyan Xu1, Yaozhong Zhang2, Huijuan Fang1
1Department of Pathology, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, China.
Pathology, Research and Practice
|April 1, 2026
Summary
Ductal carcinoma in situ (DCIS)-like invasive carcinoma is a rare breast cancer subtype that mimics DCIS, posing diagnostic challenges. Its invasive nature is confirmed by lymph node metastases with similar morphology.
Area of Science:
- Oncology
- Pathology
- Breast Cancer Research
Background:
- Ductal carcinoma in situ (DCIS)-like invasive carcinoma is a rare breast cancer variant.
- This subtype is often misdiagnosed as benign DCIS due to its similar morphology.
- Limited literature exists on its clinicopathological characteristics and diagnostic pitfalls.
Purpose of the Study:
- To characterize the clinicopathological features, immunophenotype, and diagnostic challenges of DCIS-like invasive carcinoma.
- To assess interobserver concordance for key diagnostic markers.
Main Methods:
- Retrospective review of 319 breast carcinomas, identifying 11 cases of DCIS-like invasive carcinoma.
- Evaluation of clinical, histopathological, and immunophenotypic features.
- Assessment of myoepithelial and basement membrane markers (Collagen IV, CK5/6, p63, CK14, SMA, Calponin) by 12 pathologists.
Main Results:
- 27.27% pure DCIS-like invasive carcinoma, 72.73% admixed with invasive carcinoma of no special type (IBC-NST).
- Absence of myoepithelial markers and loss of basement membrane confirmed invasiveness.
- Four patients had lymph node metastases with DCIS-like morphology; one developed cervical lymph node metastasis at 51 months.
Conclusions:
- DCIS-like invasive carcinoma is underrecognized and poses diagnostic challenges, mimicking DCIS.
- Lymph node metastases with DCIS-like morphology confirm invasive potential.
- Accurate diagnosis requires careful morphology assessment and multiple myoepithelial markers to guide management.
