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Invasion implies a breakthrough of the basement membrane of the cervical mucosa by proliferating epithelial cells. Although replacement of endocervical glands by tumor cells represents a somewhat later stage of disease, it is still intraepithelial carcinoma (stage 0). Even after careful study, it may be impossible to be certain of the presence of the earliest stages of invasion. Such borderline cases are termed intraepithelial (or in situ) carcinoma with questionable invasion. The earliest recognizable indication of invasion is the presence of microscopic "tongues" or clusters of cells, breaking the otherwise smooth junction of epithelial cells and stroma. These single or multiple points of invasion may occur either from the surface or from the tumor within glands. Although microscopic in size, these areas of invasion automatically place a case in the stage I category. These have variously been termed intraepithelial (or in situ) carcinoma with foci of microinvasion, carcinoma with early
Enterline HT. Management of Microinvasive Carcinoma. JAMA. 1965;193(3):220–221. doi:10.1001/jama.1965.03090030042011
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