{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T12:45:26Z","timestamp":1776170726019,"version":"3.50.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    In most cases, invasive ductal carcinoma (IDC) of the breast is identifiable when it presents with classic infiltrative growth patterns. However, a subset of IDC can present in a very sneaky way, significantly mimicking the appearance of ductal carcinoma\n                    <jats:italic>in situ<\/jats:italic>\n                    (DCIS). In this condition, it is 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 report the case of a 55-year-old female patient who was found to have microcalcifications at the 11:00 o\u2019clock position in the right posterior breast during a routine mammographic examination. A biopsy of the calcification area performed at an outside hospital reported high-grade DCIS (ER+, PR\u2212). Histologic examination of the subsequent mastectomy specimen at our institution showed two separate areas that closely resembled DCIS. Immunohistochemical (IHC) staining showed that all myoepithelial markers\u2014smooth muscle myosin heavy chain (SMMHC), p63, CK5\/6, and S100\u2014were retained at the periphery of the expanded acini in one of the areas. Unexpectedly and surprisingly, myoepithelial markers were completely lost at the periphery of a subset of the DCIS-looking acini in another area, a finding that was immunohistochemically consistent with the diagnosis of invasive ductal carcinoma admixed with DCIS. Knowing that invasive ductal carcinoma of the breast can exhibit a DCIS-like morphology, especially in cases where a prior biopsy has already established a diagnosis of DCIS, will enhance the awareness of pathologists to recognize invasive ductal carcinoma that mimics DCIS. In turn, this will prevent misdiagnosis and undertreatment of patients with invasive ductal carcinoma of the breast.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2025.1673998","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T17:31:38Z","timestamp":1762191098000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Sneaky DCIS-like invasive ductal carcinoma of the breast in the setting of extensive DCIS"],"prefix":"10.3389","volume":"12","author":[{"given":"Chong","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yateng","family":"Tie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinjuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niuniu","family":"Hou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"524","DOI":"10.3322\/caac.21754","article-title":"Breast cancer statistics, 2022","volume":"72","author":"Giaquinto","year":"2022","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1001\/jama.289.11.1421","article-title":"Trends in incidence rates of invasive lobular and ductal breast carcinoma","volume":"289","author":"Li","year":"2003","journal-title":"JAMA"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/j.pathol.2019.07.005","article-title":"Ductal carcinoma in situ of breast: update 2019","volume":"51","author":"Badve","year":"2019","journal-title":"Pathology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2481","DOI":"10.1002\/cncr.21069","article-title":"The natural history of low-grade ductal carcinoma in situ of the breast in women treated by biopsy only revealed over 30 years of long-term follow-up","volume":"103","author":"Sanders","year":"2005","journal-title":"Cancer"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1778","DOI":"10.1002\/cncr.20979","article-title":"Outcome of patients with ductal carcinoma in situ untreated after diagnostic biopsy: results from the nurses' health study","volume":"103","author":"Collins","year":"2005","journal-title":"Cancer"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1148\/radiol.2423051631","article-title":"Unusual breast cancers: useful clues to expanding the differential diagnosis","volume":"242","author":"Harvey","year":"2007","journal-title":"Radiology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1038\/s41416-020-01152-5","article-title":"Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK sloane project","volume":"124","author":"Shaaban","year":"2021","journal-title":"Br J Cancer"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1016\/j.prp.2004.08.006","article-title":"Ductal carcinoma in situ-like structures in metastatic breast carcinoma","volume":"200","author":"Kordek","year":"2005","journal-title":"Pathol Res Pract"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"R151","DOI":"10.1186\/bcr635","article-title":"A subset of morphologically distinct mammary myoepithelial cells lacks corresponding immunophenotypic markers","volume":"5","author":"Zhang","year":"2003","journal-title":"Breast Cancer Res"},{"key":"ref10","first-page":"3337","article-title":"Invasive ductal carcinoma with in situ pattern: how to avoid this diagnostic pitfall?","volume":"8","author":"Mohan","year":"2016","journal-title":"Am J Transl Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1374091","DOI":"10.3389\/fonc.2024.1374091","article-title":"Invasive papillary carcinoma of the breast","volume":"14","author":"Wang","year":"2024","journal-title":"Front Oncol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.29271\/jcpsp.2022.09.1196","article-title":"Clinicopathological features and prognosis of invasive micropapillary carcinoma compared to invasive ductal carcinoma-NOS: worse or better?","volume":"32","author":"Aker","year":"2022","journal-title":"J Coll Physicians Surg Pak"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1177\/1066896911435724","article-title":"Metastatic mammary carcinoma with DCIS-like morphology: a report of two cases","volume":"20","author":"Coyne","year":"2012","journal-title":"Int J Surg Pathol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/1752-1947-1-83","article-title":"Infiltrating ductal carcinoma breast with central necrosis closely mimicking ductal carcinoma in situ (comedo type): a case series","volume":"1","author":"Pervez","year":"2007","journal-title":"J Med Case Rep"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1673998\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T17:31:42Z","timestamp":1762191102000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1673998\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,3]]},"references-count":14,"alternative-id":["10.3389\/fmed.2025.1673998"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1673998","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,3]]},"article-number":"1673998"}}