Breast malignant, males, children
In situ carcinoma
Comedo DCIS / comedocarcinoma

Author: Dina Kandil, M.D. (see Authors page)

Revised: 18 October 2016, last major update January 2012

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Comedocarcinoma [title] breast

Cite this page: Comedo DCIS / comedocarcinoma. website. Accessed October 23rd, 2018.
Definition / general
  • High grade DCIS with central expansile comedonecrosis (central necrosis within involved ducts)
  • Necrosis is due to apoptosis and oncosis (passive cell death, Ultrastruct Pathol 2000;24:135)
Clinical features
  • 1/3 appear multicentric, but many are actually continuous in 3 dimensions, as demonstrated by serial section mapping studies
  • 10% are bilateral
  • 1 - 3% of patients have axillary nodal metastases, even without evidence of invasive carcinoma
  • Lesions may be extensive (> 5 cm); must examine carefully for invasive carcinoma
Radiology description
  • Mammography usually shows linear and branching microcalcifications due to calcification of necrotic material, more often central than other tumors
  • Occasionally lacks calcifications
Gross description
  • Cheesy appearance (resembling comedones) due to plugging of thick walled ducts with necrotic material
Microscopic (histologic) description
  • Solid growth of large, pleomorphic, high grade cells with central expansile necrosis
  • Frequent mitotic figures
  • Myoepithelial cell layer may be attenuated
  • Coarse microcalcifications are common
  • Periductal fibrosis and inflammation are common
  • Often cancerization of lobules
  • May have branching and budding
Microscopic (histologic) images

Images hosted on PathOut server:

Intermediate grade, courtesy of Mark R. Wick, M.D.

High grade, courtesy of Mark R. Wick, M.D.

Central necrosis with dystrophic calcifications

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Central necrosis

High nuclear grade and necrosis

Classic features


Androgen receptor+

Virtual slides

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Cytology images

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Low power

Atypical cells with large nuclei

Negative stains
Molecular / cytogenetics description
Molecular / cytogenetics images

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Tetraploid DNA

Aneuploid DNA

Differential diagnosis
Additional references