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. Author manuscript; available in PMC: 2017 Dec 1.
Published in final edited form as: Histopathology. 2016 Sep 23;69(6):1028–1046. doi: 10.1111/his.13035

Figure 8.

Figure 8

Example images from a case with a single region of potential interest to screen but borderline cytologic monotony (ADH vs UDH) and architectural changes that appear cribriform but lack polarized spaces. 31% of participants recorded an ADH diagnosis for the case, 59% recorded a Benign diagnosis (94% UDH) and 7% recorded a LN diagnosis, and 3% recorded a DCIS diagnosis (29 total interpretations). When the both the architectural and the cytologic features are borderline between UDH and ADH, diagnostic disagreement is more likely. Additional levels, immunohistochemistry (CK5/6, ER or the ADH5 stain) and additional opinions can be helpful in this differential if these findings are present on a core needle biopsy where it would be most clinically relevant. Given the findings on the single H&E slide available in this test set, the expert panel classified this lesion as ADH based on the architectural atypia present and subtle monotony. However, the findings are borderline with UDH, which can be mentioned in the report.