Both slides were reviewed and additionally reviewed in staff conference. Recut H&E stains x2 were prepared from both submitted blocks and immunostains for calponin and p63 were prepared from both blocks. Viewers concurred there are foci of DCIS Grade lll involving cores on both slides, with focal central comedo-type necrosis noted. No microinvasion is appreciated, confirmed by retained myoepilnelial cells highlighted by the p63 and calponin immunostains. Also present are portions of papillary DCIS, an intraductal papilloma, and an incidental hyalinized fibroadenoma with focal involvement by DCIS grade ll (slide A1). The papillary carcinoma shows moderate-marked cytologic atypic but myoepithelial cells are retained about the periphery (where evaluable), confirmed by positive staining for calponin and p63. Papillary neoplasms may be heterogeneous and when only partially sampled by biopsy, complete excision is recommended, if clinically feasible, for complete evaluation.
Philip A Branton MD FCAP
Consultant Contract Surgical Pathologist
Biorepositories and Biospecimens Research Branch/BBRB
Cancer Diagnosis Program
National Cancer Institute