AVP and ductal breast carcinoma in situ: In contrast, CCLs with atypia are considered true precursor lesions of the low nuclear grade breast cancer family [4–7], with upgrade rates of 5–9% [8, 9] and an association with more advanced lesions (ADH [10–16], DCIS grade 1 [1, 11, 14, 17, 18], lobular neoplasia [10, 12, 14, 16, 19–22], and tubular cancer [7, 17, 19, 20, 23, 24]) in about 20% of patients [25].