CASE REPORT article
Front. Med.
Sec. Pathology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1673998
Case Report: Sneaky DCIS-looking Invasive Ductal Carcinoma of the Breast in the Background of Extensive DCIS
Provisionally accepted
- 1Air Force Medical University, Xi'an, China
- 2The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- 3UC Irvine Medical Center, Irvine, United States
- 4University of California San Francisco Department of Pathology, San Francisco, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
In the most cases, invasive ductal carcinoma (IDC) of the breast is identifiable when they present with classic infiltrative growth pattern. However, subset of IDC can occur in a very sneaky way, significantly mimicking the appearance of ductal carcinoma in situ (DCIS). In this condition, it's much easier to miss the invasive component without pulling ancillary staining when morphologic findings are extremely compatible with DCIS, especially the diagnosis of DCIS was made on the previous biopsy. Here, we reported a 55 year-old female who was noted to have microcalcification at the 11:00 o'clock of the right posterior breast on routine mammographic examination. Biopsy of the calcification area in outside hospital reported high grade DCIS (ER+ PR-). Histologic examination of subsequent mastectomy specimen at our institution showed two separate similar DCIS-looking areas. Immunohistochemical (IHC) staining showed that all the myoepithelial markers, smooth muscle myosin heavy chain (SMMHC), p63, CK5/6 and S100, were retained at the periphery of the expanded acini in one area. Unexpectedly and surprisingly, myoepithelial markers were completely lost at the periphery of part of the DCIS-looking acini in another area, immunohistochemically compatible with the diagnosis of invasive ductal carcinoma admixed with DCIS. Knowing that invasive ductal carcinoma of the breast can present as DCIS-looking morphology, especially given the condition that the diagnosis of DCIS was rendered on the previous biopsy, will enhance awareness of pathologists to recognize DCIS-looking invasive ductal carcinoma. In turn, this will prevent misdiagnosis and under-treatment of patients with invasive ductal carcinoma of the breast.
Keywords: ductal carcinoma in situ, invasive ductal carcinoma, breast cancer, Breast tumor, DCIS-like IDC
Received: 12 Sep 2025; Accepted: 15 Oct 2025.
Copyright: © 2025 Chen, Tie, Zhang, Hou, Song and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dong Ren, dren3@hs.uci.edu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.