<s>[INST] context: Refer Robbins page no 1057 DCIS can be divided into two major architectural subtypes, comedo and noncomedo (Fig. 23-17). Some cases of DCIS have a single growth pattern, but most are comprised of a mixture of patterns. Nuclear grade and necrosis are better predictors of local recurrence and progression to invasion than architectural type. Comedo DCIS may occasionally produce vague nodularity, but more often it is detected on mammography as clustered or linear and branching areas of calcification (Fig. 23-17A). It is defined by two features: (1) tumor cells with pleomorphic, high- grade nuclei and (2) areas of central necrosis (Fig. 23-17B). Noncomedo DCIS lacks either high-grade nuclei or central necrosis. Several patterns may be seen. Cribriform DCIS may have rounded (cookie cutter-like) spaces (Fig. 23-17C) within the ducts, or a solid DCIS pattern. Micropapillary DCIS pro- duces bulbous protrusions without a fibrovascular core, often arranged in complex intraductal patterns (Fig. 23-17D). In other cases, DCIS produces true papillae with fibrovascular cores that lack a myoepithelial cell layer. Calcifications may also be seen in noncomedo forms of DCIS in association with focal necrosis or intraluminal secretions. [/INST] question: Commonest carcinoma of the with multifocal origin is | options: A: Schirrhous carcinoma B: Adenocystic carcinoma C: Lobular carcinoma D: Ductal carcinoma | answer: D </s>