Influence of Cancerization of Lobules in Ductal Carcinoma In Situ of the Breast on the Pathological Outcomes in Mastectomy Specimens

Sep 23, 2026

Uploaded by Eliana

Cancerization of lobules (COL) refers to lobular acini involved by ductal carcinoma in situ (DCIS), and its significance for invasion risk remains uncertain. This study tested whether COL predicts adverse pathology in mastectomy specimens by reviewing clinicopathological data and re-evaluating whole-tissue H&E slides. Among 171 DCIS cases, COL correlated with higher DCIS nuclear grade, central “comedo” necrosis, close or positive resection margins, greater DCIS extent, and extensive intraductal component. COL did not increase the likelihood of detecting invasive carcinoma and showed no clear impact on invasion-associated outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Abstract

Introduction

Breast cancer epidemiology and incidence

Methods

Study population and specimen review

Pathological assessment and immunohistochemistry

Results

Associations between COL and adverse pathology

Invasion outcomes with and without COL

Conclusions

Article Influence of Cancerization of Lobules in Ductal Carcinoma In Situ of the Breast on the Pathological Outcomes in Mastectomy Specimens Ferial Alloush 1,†, Hisham F. Bahmad 1,2, *,†, Arunima Deb 1, Stephanie Ocejo 3, Ann-Katrin Valencia 3, Amr Abulaban 2, Kritika Krishnamurthy 4, Sarah Alghamdi 1,5 and Robert Poppiti 1,5 Academic Editor: Cynthia Ma Received: 7 April 2025 Revised: 27 April 2025 Accepted: 9 May 2025 Published: 12 May 2025 Citation: Alloush, F.; Bahmad, H.F.; Deb, A.; Ocejo, S.; Valencia, A.-K.; Abulaban, A.; Krishnamurthy, K.; Alghamdi, S.; Poppiti, R. Influence of Cancerization of Lobules in Ductal Carcinoma In Situ of the Breast on the Pathological Outcomesin Mastectomy Specimens. Cancers 2025, 17, 1634 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers17101634 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) . 1 The Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL 33140, USA; [ferial.alloush@msmc.com](ferial.alloush@msmc.com) (F.A.); [arunima.deb@msmc.com](arunima.deb@msmc.com) (A.D.); [sarah.alghamdi@msmc.com](sarah.alghamdi@msmc.com) (S.A.); [robert.poppiti@msmc.com](robert.poppiti@msmc.com) (R.P.) 2 Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA; [amr.abulaban@jhsmiami.org](amr.abulaban@jhsmiami.org) 3 Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; socej001@med.fiu.edu (S.O.); avale115@med.fiu.edu (A.-K.V.) 4 Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, USA; [kritika.myspace@gmail.com](kritika.myspace@gmail.com) 5 Department of Pathology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA * [Correspondence: hfbahmad@gmail.com or hxb592@miami.edu](Correspondence: hfbahmad@gmail.com or hxb592@miami.edu); Tel.: +1-305-243-7284 † These authors contributed equally to this work. Simple Summary: Cancerization of lobules (COL) occurs when the breast lobular acini are involved by ductal carcinoma in situ (DCIS), but its role in predicting invasive carcinoma remains unclear. Our study evaluated whether COL is linked to worse pathological outcomes in mastectomy specimens. We analyzed 171 cases of DCIS and found that COL is associated with factors indicating a higher disease burden, such as higher DCIS grade, central (“comedo”) necrosis, and extensive intraductal component (EIC) . However, the presence of COL was not associated with an increased likelihood of detecting an invasive component. These findings suggest that COL may reflect a greater extent of disease but isnot a direct predictor of invasion. Abstract: Cancerization of lobules (COL) is defined as the involvement of lobular acini by ductal carcinoma in situ (DCIS) . Whether it represents a morphological variation in DCIS ora secondary extension of DCIS into lobules is debatable. The relation between COL and the probability of invasion is conflicting among different studies. We assessed if COL is a predictor of adverse pathological outcomes in mastectomy specimens. We reviewed the clinicopathological data of patients who underwent partial or total mastectomy for DCIS during a 3-year period (January 2015 until December 2017) . Pathological parameters and follow-up data were collected. Whole-tissue hematoxylin and eosin (H&E) slides were reviewed andre-evaluated for COL. Cases with COL were stained immunohistochemically for E-cadherinand p120 to confirm the ductal phenotype of the neoplasms. In total, 171 mastectomies wer

FAQs

What is cancerization of lobules (COL) in the context of DCIS?

COL describes involvement of lobular acini by ductal carcinoma in situ (DCIS). The study examines whether this morphological finding reflects higher disease burden and whether it relates to invasion probability.

How was COL assessed and confirmed in this study?

Whole-tissue H&E slides were reviewed and re-evaluated for COL. Cases with COL were also stained immunohistochemically for E-cadherin and p120 to confirm the ductal phenotype.

Does COL predict a higher likelihood of detecting invasive carcinoma in mastectomy specimens?

No. Invasion was observed in about two-thirds of cases regardless of COL presence, with no statistical significance for increased detection of invasive carcinoma.

Sep 23, 2026

Uploaded by Eliana