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http://dx.doi.org/10.7314/APJCP.2014.15.1.55

Factors Predicting Microinvasion in Ductal Carcinoma in situ  

Ozkan-Gurdal, Sibel (Department of Surgery, School of Medicine, Namik Kemal University)
Cabioglu, Neslihan (Department of Surgery, Istanbul Medical Faculty, Istanbul University)
Ozcinar, Beyza (Department of Surgery, Istanbul Medical Faculty, Istanbul University)
Muslumanoglu, Mahmut (Department of Surgery, Istanbul Medical Faculty, Istanbul University)
Ozmen, Vahit (Department of Surgery, Istanbul Medical Faculty, Istanbul University)
Kecer, Mustafa (Department of Surgery, Istanbul Medical Faculty, Istanbul University)
Yavuz, Ekrem (Departments of Pathology, Istanbul Medical Faculty, Istanbul University)
Igci, Abdullah (Department of Surgery, Istanbul Medical Faculty, Istanbul University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.15, no.1, 2014 , pp. 55-60 More about this Journal
Abstract
Background: Whether sentinel lymph node biopsy (SLNB) should be performed in patients with pure ductal carcinoma in situ (DCIS) of the breast has been a question of debate over the last decade. The aim of this study was to identify factors associated with microinvasive disease and determine the criteria for performing SLNB in patients with DCIS. Materials and Methods: 125 patients with DCIS who underwent surgery between January 2000 and December 2008 were reviewed to identify factors associated with DCIS and DCIS with microinvasion (DCISM). Results: 88 patients (70.4%) had pure DCIS and 37 (29.6%) had DCISM. Among 33 DCIS patients who underwent SLNB, one patient (3.3%) was found to have isolated tumor cells in her biopsy, whereas 1 of 14 (37.8%) patients with DCISM had micrometastasis (7.1%). Similarly, of 16 patients (18.2%) with pure DCIS and axillary lymph node dissection (ALND) without SLNB, none had lymph node metastasis. Furthermore, of 20 patients with DCISM and ALND, only one (5%) had metastasis. In multivariate analysis, the presence of comedo necrosis [relative risk (RR)=4.1, 95% confidence interval (CI)=1.6-10.6, P=0.004], and hormone receptor (ER or PR) negativity (RR=4.0, 95%CI=1.5-11, P=0.007), were found to be significantly associated with microinvasion. Conclusions: Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with comedo necrosis or hormone receptor negativity are more likely to have a microinvasive component in definitive pathology following surgery, and should be considered for SLNB procedure along with patients who will undergo mastectomy due to DCIS.
Keywords
Ductal carcinoma in situ; sentinel lymph node biopsy; microinvasion;
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1 Intra M, Rotmensz N, Veronesi P, et al (2008). Sentinel node biopsy is not a standard procedure in ductal carcinoma in situ of the breast. Ann Surg, 247, 315-9.   DOI   ScienceOn
2 Zavagno G, Belardinelli V, Marconato R, et al(2007). Sentinel lymph node metastasis from mammary ductal carcinoma in situ with microinvasion. Breast, 16, 146-51.   DOI   ScienceOn
3 Houghton J, George WD, Cuzick J (2003). Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK, Australia, and New Zealand: randomised controlled trial. Lancet, 362, 95-102.   DOI   ScienceOn
4 Greenlee RT, Hill-Harmon MB, Murray T, et al (2001). Cancer statistics 2001. CA Cancer J Clin, 51, 15-36.   DOI   ScienceOn
5 Ikeda DM, Andersson I (1989). Ductal carcinoma in situ: atypical mammographic appearances. Radiology, 172, 661-6.   DOI
6 Intra M, Zurrida S, Maffini F, et al (2003). Sentinel lymph node metastasis in microinvasive breast cancer. Ann Surg Oncol, 10, 1160-5.   DOI
7 Katz A, Gage I, Evans S, et al (2006).Sentinel lymph node positivity of patients with ductal carcinoma in situ or microinvasive breast cancer. Am J Surg, 191, 761-6.   DOI   ScienceOn
8 Wilkie C, White L, Dupont E, et al (2005). An update of sentinel lymph node mapping in patients with ductal carcinoma in situ. Am J Surg, 190, 563-6.   DOI   ScienceOn
9 Winchester DP, Menck HR, Osteen RT, et al (1995). Treatment trends for ductal carcinoma in situ of the breast. Ann Surg Oncol, 2, 207-13.   DOI
10 Yen TW, Hunt KK, Ross MI, et al (2005). Predictors of invasive breast cancer in patients with an initial diagnosis of ductal carcinoma in situ: a guide to selective use of sentinel lymph node biopsy in management of ductal carcinoma in situ. J Am Coll Surg, 200, 516-26.   DOI   ScienceOn
11 Yu KD, Wu LM, Liu GY, et al (2011). Different distribution of breast cancer subtypes in breast ductal carcinoma in situ (DCIS), DCIS with microinvasion, and DCIS with invasion component. Ann Surg Oncol, 18, 1342-8.   DOI
12 Cutuli B, Cohen-Solal-Le Nir C, De Lafontan B, et al (2001). Ductal carcinoma in situ of the breast results of conservative and radical treatments in 716 patients. Eur J Cancer, 37, 2365-72.   DOI   ScienceOn
13 Baxter NN, Virnig BA, Durham SB, et al (2004). Trends in the treatment of ductal carcinoma in situ of the breast. J Natl Cancer Inst, 96, 443-8.   DOI   ScienceOn
14 Boyages J, Delaney G, Taylor R (1999). Predictors of local recurrence after treatment of ductal carcinoma in situ: a meta-analysis. Cancer, 85, 616-28.   DOI
15 Cavaliere A, Scheibel M, Bellezza G, et al (2006). Ductal carcinoma in situ with microinvasion: clinicopathologic study and biopathologic profile. Pathol Res Pract, 202, 131-5.   DOI   ScienceOn
16 Adlard JW, Bundred NJ (2006). Radiotherapy for ductal carcinoma in situ. Clin Oncol, 18, 179-84.   DOI   ScienceOn
17 Altintas S, Lambein K, Huizing MT, et al (2009). Prognostic significance of oncogenic markers in ductal carcinoma in situ of the breast: a clinicopathologic study. Breast J, 15, 120-32.   DOI   ScienceOn
18 Edge SB, Byrd DR, Compton CC, et al (2009). AJCC Cancer Staging Handbook, seventh edition. Chicago: Springer, pp419-60.
19 Daly MB (2006). Tamoxifen in ductal carcinoma in situ. Semin Oncol, 33, 647-9.   DOI   ScienceOn
20 Dershaw DD, Abramson A, Kinne DW (1989). Ductal carcinoma in situ: mammographic findings and clinical implications. Radiology, 170, 411-5.   DOI
21 Ernster VL, Barclay J, Kerlikowske K, et al (1996). Incidence of and treatment for ductal carcinoma in situ of the breast. JAMA, 275, 913-8.   DOI   ScienceOn
22 Fisher B, Dignam J, Wolmark N, et al (1998). Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from national surgical adjuvant breast and bowel project B-17. J Clin Oncol, 16, 441-52.
23 Silverstein MJ, Lagios MD, Groshen S, et al (1999). The influence of margin width on local control of ductal carcinoma in situ of the breast. N Engl J Med, 340, 1455-61.   DOI   ScienceOn
24 Sakr R, Barranger E, Antoine M, et al (2006). Ductal carcinoma in situ: value of sentinel lymph node biopsy. J Surg Oncol, 94, 426-30.   DOI   ScienceOn
25 Silver SA, Tavassoli FA (1998). Mammary ductal carcinoma in situ with microinvasion. Cancer, 82, 2382-90.   DOI
26 Silverstein MJ (2003). The University of Southern California/ Van Nuys prognostic index for DCIS of the breast. Am J Surg, 186, 337-43.   DOI   ScienceOn
27 Silverstein M, Skinner K, Lomis T (2001). Predicting axillary nodal positivity in 2282 patients with breast carcinoma. World J Surg, 25, 767-72.   DOI   ScienceOn
28 Tan JC, McCready DR, Easson AM, et al (2007). Role of sentinel lymph node biopsy in ductal carcinoma in-situ treated by mastectomy. Ann Surg Oncol, 14, 638-45.   DOI
29 Silverstein MJ, Waisman JR, Gamagani P, et al (1990). Intraductal carcinoma of the breast (208 cases). Clinical factors influencing treatment of choice. Cancer, 66, 102-8.   DOI
30 Skinner KA, Silverstein MJ (2001). The management of ductal carcinoma in situ of the breast. Endocr Relat Cancer, 8, 33-45.   DOI   ScienceOn
31 Vieira CC, Mercado CL, Cangiarella JF, et al (2010). Microinvasive ductal carcinoma in situ: Clinical presentation, imaging features, pathologic findings, and outcome. Eur J Radiol, 73, 102-7.   DOI   ScienceOn
32 Wei Z, Er-li G, Yi-li Z, et al (2012). Different distribution of breast ductal carcinoma in situ, ductal carcinoma in situ with microinvasion, and invasion breast cancer. World J Surg Oncol, 10, 262.   DOI
33 Anderson B (2000). Axillary metastases with DCIS: is the glass half empty or half full? Ann Surg Oncol, 7, 631-3.   DOI   ScienceOn
34 Ozmen V, Karanlik H, Cabioglu N, et al (2006). Factors predicting the sentinel and non-sentinel lymph node metastases in breast cancer. Breast Cancer Res Treat, 95, 1-6.   DOI
35 Lagios MD, Margolin FR, Westdahl PR, et al (1989). Mammographically detected duct carcinoma in situ. Frequency of local recurrence following tylectomy and prognostic effect of nuclear grade on local recurrence. Cancer, 63, 618-24.   DOI
36 Mirza NQ, Vlastos G, Meric F, et al (2000). Ductal carcinoma in situ: long term results of breast-conserving therapy. Ann Surg Oncol, 7, 656-64.   DOI   ScienceOn
37 Mabry H, Giuliano AE, Silverstein MJ (2006). What is the value of axillary dissection or sentinel node biopsy in patients with ductal carcinoma in situ? Am J Surg, 192, 455-7.   DOI   ScienceOn
38 Park SY, Lee HE, Li H, et al (2010). Heterogeneity for stem cellrelated markers according to tumor subtype and histologic stage in breast cancer. Clin Cancer Res, 16, 876-87.   DOI
39 Roses RE, Paulson C, Sharma A, et al (2009). HER-2/neu overexpression as a predictor for the transition from in situ to invasive breast cancer. Cancer Epidemiol Biomarkers Prev, 18, 1386-9.   DOI   ScienceOn
40 Rosner D, Bedwani RN, Vana J, et al (1980). Noninvasive breast carcinoma: results of a national survey by the American College of surgeons. Ann Surg, 192, 139-47.   DOI   ScienceOn