Abstract

Abstract: The spectrum of epithelial proliferations within the mammary duct system includes lobular, ductal, and papillary patterns of proliferation. Among those with a ductal growth pattern, the highest proportion qualifies as ordinary intraductal hyperplasia (IDH), a small proportion shows atypical intraductal hyperplasia (AIDH), and a steadily increasing percentage is composed of intraductal carcinomas (IDCA). AIDH and some variants of IDCA share many characteristics and their distinction can be quite troublesome, in some cases relying completely on an arbitrary quantitative criterion. IDH, however, is quite distinctive from both a morphologic and biologic standpoint and should not be confused with AIDH. This review discusses our criteria for diagnosing IDH, AIDH, and IDCA, followed by a review of the common subtypes of IDCA and a presentation of our approach to grading IDCA. The clinical significance and expression of estrogen and progesterone receptor (ER and PR), as well as expression of Ki67 and p53 in IDH, AIDH, and various grades of IDCA are presented.

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