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Case Report Volume 17 issue 5
Structural dedifferentiation of breast cancer arising within the major lactiferous ducts: imaging-histopathologic correlation in two fatal cases
László Tabár, Peter B Dean, Miklós Tarján
Department of Mammography, Falun Central Hospital, Sweden
Department of Diagnostic Radiology, Faculty of Medicine, University of Turku, Finland
Department of Clinical Pathology and Cytology, Falun Central Hospital, Sweden
Received: September 15, 2026 | Published: September 22, 2026
Citation: Tabár L, Dean PB, Tarján M. Structural dedifferentiation of breast cancer arising within the major lactiferous ducts: imaging-histopathologic correlation in two fatal cases. J Cancer Prev Curr Res. 2026;17(4):139‒147. DOI: 10.15406/jcpcr.2026.17.00621
Abstract
Background: Malignant neoducts arising within the major lactiferous ducts of the breast through the process of neoductgenesis undergo structural dedifferentiation, which facilitates their metastatic dissemination. The fatality of these malignancies continues to be significantly greater than that of cancers arising within the breast lobules, despite the accomplishments of early detection and the therapeutic innovations introduced over recent decades. Precis: This report describes two fatal breast cancer cases, both of which demonstrate the documented association between structural dedifferentiation and breast cancer fatality. The 1st phase of progression of breast cancer originating within the major lactiferous ducts, ductal carcinoma in situ (DCIS), cannot be demonstrated with currently available imaging methods. The 2nd phase of progression, ductal adenocarcinoma of the breast (DAB), and the 3rd phase, dedifferentiated ductal adenocarcinoma of the breast (ddDAB) of this complex cancer progression are richly illustrated. An appreciation of the process of structural dedifferentiation of cancers originating within the major ducts will be key to improving the outcome of this highly fatal breast cancer subgroup. Case description: Case 1 represents the fluid-producing diffuse breast cancers of ductal origin. Three imaging biomarkers characterize this case: extensive architectural distortion, an associated cluster of microcalcifications on the mammogram, and galactographic findings. The patient’s bloody nipple discharge prompted the galactographic examination. Architectural distortion on the mammogram correlates with the fluid-filled cancerous neoducts on the galactogram. Three months after the diagnosis and initiation of treatment, the patient was diagnosed with lung metastases that had histopathologic and immunohistochemical features similar to those of the malignant neoducts (DAB) in the breast. Eight months after diagnosis the patient died from DAB and ddDAB. Case 2 is a combination of extensive DAB and multifocal ddDAB, where the histopathologic picture of the DAB is dominated by central necrosis. Axillary lymph node metastases and a recurrence in the chest wall correspond to the 2nd phase (neoducts, DAB) and the 3rd phase (ddDAB) in the evolution of this breast malignancy originating within the major lactiferous ducts. The histopathologic image of the 3 rd phase (ddDAB) dominated the picture in the liver metastases. Twelve months after initial diagnosis the patient died from DAB and ddDAB. Conclusion: The imaging biomarkers and large section histopathology are consistent with the model of tumour development within the major lactiferous ducts. Breast cancer arising within the major ducts can be characterized by the production of necrosis and fluid in varying combinations. The imaging and histopathologic features of these two cases as well as their poor outcome are typical for DAB and ddDAB.
Keywords: mammography, breast cancer neoducts, neoductgenesis, dedifferentiation of neoducts, imaging biomarkers
©2026 Tabár, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.