At the ASCP 2026 Annual Meeting, Yuanxin Liang will present practical, case-based advice to help clear up potential gray areas when trying to distinguish between ADH and DCIS, including dealing with atypical apocrine features.
The following transcript has been edited for clarity.
Hi everyone, my name is Yuanxin Liang. I am an assistant professor of pathology at Yale School of Medicine.
If you look at breast pathology in your daily practice, you already know how frustrating it is to draw a line between ADH and DCIS. The gray area of ADH bordering on DCIS is a huge diagnostic headache. It causes a lot of disagreement between pathologists and that makes it really tough for clinical teams to decide how to treat the patients. It makes things even harder when a tumor has apocrine features – the line becomes even more unclear.
In my upcoming session, we are going to look at some real practical data to help clean up this confusion. I will show you what we learned from multi-institutional study on how pathologists look at these borderline cases.
We found interesting things. Even when pathologists agree on the same small details on the slice, they often end up with completely different final diagnoses because they give different weight to different features.
We will also look at our recent research on tricky apocrine features, so you can tell the difference between a typical change and atypical apocrine-type DCIS.
We are going to look at real cases with microscopic imaging and the exact kind of tough slice you see on your daily practice. I hope you will leave this session with a better idea on how to handle these borderline cases with confidence.
Thank you very much for watching, and see you at the meeting.
Newsletters
Receive the latest pathologist news, personalities, education, and career development – weekly to your inbox.
