Ductal Carcinoma In Situ (DCIS) of the Breast; Clinico-pathological Analysis, Expression of Molecular Markers, and Correlations between Known Prognostic Factors.
- Author:
Sung Soo KANG
1
;
Seung Sang KO
;
Back Hyun JO
;
Min Hee HUR
;
Hae Kyung LEE
;
Sung Kong LEE
;
Yi Kyeong CHUN
;
Yee Jeong KIM
;
Kyung Sang LEE
;
Sung Ran HONG
;
Jee Hyun LEE
Author Information
1. Department of Surgery, , Samsung Cheil Hospital & Women's Healthcare Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kang1018@samsung.co.kr
- Publication Type:Original Article
- Keywords:
Breast cancer;
Ductal carcinoma in situ (DCIS);
Molecular markers
- MeSH:
Breast Neoplasms;
Breast*;
Carcinoma, Ductal*;
Carcinoma, Intraductal, Noninfiltrating*;
Diagnosis;
Female;
Follow-Up Studies;
Humans;
Immunohistochemistry;
Lymph Nodes;
Mammography;
Mass Screening;
Mortality;
Prevalence;
Recurrence
- From:Journal of the Korean Surgical Society
2003;64(4):289-295
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The improved availability of breast cancer screening, including mammography, has dramatically increased the detection rate of DCIS (ductal carcinoma in situ). However, there has been controversy regarding the clinico-pathological characteristics and optimal management of DCIS. This analysis was conducted in order to evaluate the clinico- pathological findings of DCIS, and any possible correlations between the known prognostic factors. METHODS: We analyzed 58 consecutive cases of DCIS, from 1990 to 1995, including data on the annual proportion of DCIS to total breast cancer cases, the clinico-pathological characteristics and the expressions of ER, PR, c-erbB-2 and p53. The median length of follow-up was 98.5 months. RESULTS: The proportion of DCIS was 8.8%, with progressive increases from 1990 to 1995. The mean age at diagnosis was 47.1 years, with the peak of prevalence seen in women aged 40~49 years. The most common presentation was a palpable breast mass in 28 (48.3%) cases, but 18 (31%) patients were asymptomatic. The mammographic findings demonstrated calcification in 75% and mass density in 59.6%. There was only 1 (1.8%) case of a bilateral lesion, and 5 (8.6%) of multifocal or multicentric lesions. Axillary lymph nodes were positive in 5.5% of the patients who underwent an axillary dissection. Breast conserving operations were performed in 8 (13.8%) cases. The frequencies of ER, PR, c-erbB-2 and p53, positivity, by immunohistochemistry were 52, 50, 55.1 and 30.6%, respectively. c-erbB- 2 immunoreactivity was found more often in DCIS with larger size, higher nuclear grade and negative ER and PR (P= 0.011, P=0.001, P=0.002, and P=0.006, respectively). There was a significant association between higher nuclear grade and negative ER and PR, and comedotype (P=0.001, P= 0.000, and 0.008, respectively). Although an invasive ductal carcinoma had developed in 5.4% of the contralateral breasts, there were no cases of systemic relapse, or disease-specific mortality, at the last follow-up.
