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Abstract
Careful microscopic examination of biopsies especially imucoid carcinoma to be insure of the malignant criteria of the cells, and serial sections in case of mucocele like lesion to exclude mucoid carcinoma in adjoining tissue or excisional biopsy if MLL was diagnosed on core needle biopsy.
Also careful examination in case of Paget disease as misinterpretation of Taker (pseudo-Paget} cells as Paget cells could have serious consequences .The malignant criteria, infiltration of the basal layer and .
the presence of DCIS in terminal portion of lactiferous duct suffice to corroborate the diagnosis of PDN.
Any fibrocystic disease or other inflammatory lesions must be carefully examined to exclude any columnar cell hyperplasia which of high risk to give duct carcinoma and so it need follow up and genetic mapping.
PASH may resemble vascular lesion .It can be differentiated immunohistochemically from vascular lesions using factor VIII.
PLeIS can be differentiated from DCIS using Immunostain with Ecadherin, which is positive in DCIS and negative in PLCIS. This differentiation is very important because achievement of negative
margins in all forms of LeIS is an elusive objective; whereas, in DCIS negative margins are a necessary goal to achieve breast conservation. Also careful examination in cases of DCIS to exclude microinvasion.