Individual duct may not be quite enought for DCIS; but the overall size is quite big - I think it is enought for a DCIS (低级别导管内癌); No invasion or microinvasion is seen on these photographs. Thanks.

 First four photos seem to be solid papillary carcinoma. Suggest IHC for myoepithelial markers.

Solid papillary carcinoma: absence of myoepithelial cells within the cellular proliferation is chracteristic. Myoepithelial cells around the peripheries of neoplastic nodules may be absent also. The tumor can have endocrin features with positive stains for chromogranin and synaptophysin. It is a variant of DCIS. Some breast pathologists think that at least some of the cases may represent nests of invasive carcinoma (if no myoepithelial cells around the peripheries). Anyway solid papillary carcinoma has an indolent clinical course. Just for your reference.

abin译：

前四图似乎是实体性乳头状癌（SPC），建议检测肌上皮标记。

SPC：在细胞丰富的增生区域缺乏肌上皮，具有特征性。肿瘤性结节的周围，肌上皮细胞也可能缺失。肿瘤可有神经内分泌特征，嗜铬素（CgA）和突触素（SYN）阳性。它是DCIS的一种亚型。一些乳腺病理学家认为至少部分病例可以出现浸润癌巢（如果周围缺少肌上皮细胞）。总之，SPC在临床上呈惰性过程。

仅供参考。

 1. Solid papillary carcinoma without frank invasion, variant of DCIS.

2. Last four photos: atypical papilloma vs focal DCIS within Papilloma (it is not important because you have above diagnosis already)

abin译：

1.无明显浸润的SPC，DCIS的亚型。

2.后四图：不典型乳头状瘤/乳头状瘤内局灶性DCIS（这一条不太重要因为已经有了上述诊断）。

See the photos again.

There are two diagnosis lines

1. Solid papillary carcinoma (Why? first four photos show large circumscribed celluar nodeles separated by fibrous tissue).

2. Atypical papilloma (other photos)

abin译：

再次看图。

列出两个诊断：

1.SPC（为什么？前四图显示大面积界清的富细胞性结节，由纤维组织分隔）。

2.不典型乳头状瘤（其它图）。

It's very interesting that we look at the same picture but have different interpretation.  I did not see obvious papillary lesion as Dr. Zhao. My interpretation of this lesion is: DCIS of solid growth pattern with cancerization of adjacent lobules. It is also associated with columnar cell hyperplasia and ADH. We all seem to agree it is DCIS and the risk of invasive cancer and treatment should be the same.  Thanks.

abin译：
我们经常会遇到这种情况，看到相同图片却产生不同见解，这很有趣。我没有像Dr.Zhao看到明显的乳头状病变。我的观点是：实性生长型DCIS，伴邻近小叶癌化。也伴有柱状细胞增生和ADH。我们似乎都同意它是DCIS性质和进展为浸润癌的风险以及相同的临床处理。
谢谢。

 非常感谢这楼上各位老师的分析，特别感谢Dr.Zhao和Dr.Stevenshen的深入讨论。

习惯查阅中文资料的朋友，可以参考《中华病理学杂志》2006年第10期上的两篇文献，谈到SPC和EDCIS以及它们之间的关系。我们论坛以前也有关于EDCIS的讨论

（乳腺冰冻之五--F55Y乳头溢液http://www.ipathology.org.cn/forum/forum_display.asp?classcode=148&keyno=30689&pageno=1）。

 谢谢楼主！非常清晰的图片，赞！

试着描述：管状腺体或细胞岛增生，细胞岛内细胞不单一，腺腔大小不一、分布不均，多为边窗，管状腺体双层细胞（有肌上皮）。

如果发生在乳头附近，考虑：乳头腺瘤。核分裂较多，伴ADH。

不知对否？请老师讲解！期待免疫组化和最后结果...

神经内分泌癌！