My understanding is that necrosis is the dead cells; they can see the cell “trash”. In normal cell death process (apoptosis) our bodies work to absorb the dead cell trash. When cancer cells are multiplying quickly the body can’t absorb the dead stuff fast enough. So necrosis is a sign of cancer cell proliferation (again, this is my unprofessional opinion of what I’ve read and been told/remember from the oncologist/radiologist). Cancer cells are drawn to an environment where they can survive. When necrosis builds up, it’s pushed to the middle of the duct and the live cancer cells start seeking more space to replicate - which can eventually push outside the duct (my explanation). Technically - I think comedo defines a large grouping or bump (like in dermatology) so comedonecrosis is a large bump of dead cells.
Miotic rate is part of their decision making to determine a cancer grade. We don’t see that number. But to grade your biopsy tissue they HAD to consider miotic rate. And it tells them how fast the cells are replicating. To me, if the cancer is growing fast it puts me at a higher risk of metastasis.
If you’re going to ask about the miotic rate, you’d probably want to know if a person or machine did the counting, and whether they only counted a small sample. Small sampling can give inconsistent results because it may not be a good example of the cancer, they may have just randomly picked a small sample that only had slow growing cells but other faster growing cells would have been seen in another sample. Counting an entire slice of the cancer is reported to be very tedious and time consuming - that equates to $$ and extra staff. I think the computerized version to count is getting more accurate (AI or machine learning) but in the recent past the computer wasn’t as accurate determining which cells to count or to exclude.
Sorry this is so long - I read a lot of research and can get way too detailed when answering. Tamoxifen comments in next post.