DataDuctal adenocarcinoma of the prostate

Direct links plus the targets, companies, and technologies of this cancer's products.

• Ductal is not intraductal. They sound alike, they are often found in the same gland, and they mean different things. Ductal adenocarcinoma is an invasive cancer whose cells look like duct lining; intraductal carcinoma of the prostate is cancer growing inside ducts and acini that still have their own basal cell layer, a pattern reported beside an invasive cancer rather than a tumour type of its own. Both are reasons for germline testing and both mean a worse outlook, which is probably why the two words get run together.
• Why a needle biopsy report says 'adenocarcinoma with ductal features' instead. The WHO fifth edition reserves the term ductal adenocarcinoma for prostatectomy specimens where more than half the tumour is ductal, and asks for 'adenocarcinoma with ductal features' on needle biopsies whether the sample is pure or mixed, because a needle cannot measure the proportion in the whole gland. A report using the longer phrase is following the classification, not hedging.
• Why the incidence figures disagree so much. The meta-analysed range across case series is 0.084 to 13.4 percent, a spread of more than a hundredfold, and the reason is diagnostic rather than biological: there is no single agreed histological definition, twenty expert uropathologists agreed on a positive ductal diagnosis in 52 percent of cases, and systematic biopsy misses the ductal component in most cases that MRI-targeted biopsy finds. Any single number quoted for how common ductal prostate cancer is should be read as an estimate of how often it is recognised.

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