Published online Mar 31, 2008.
https://doi.org/10.4048/jbc.2008.11.1.36
Predictive Factors of Residual Invasive Breast Cancer after Core Biopsy for Ductal Carcinoma in Situ
Abstract
Purpose
We wanted to identify the clinicopathologic factors that predict the presence of invasive cancer after core biopsy for ductal carcinoma in situ (DCIS).
Methods
The patients diagnosed with ductal carcinoma in situ on core biopsy (stereotactic or ultrasound) from February 2003 to May 2007 were identified by retrospectively reviewing the collected data. We analyzed the demographic data, the characteristics on the imaging studies and the histologic features on DCIS. We assessed the factors that included age, the physical examination, the radiologic findings, the biopsy method, and the histologic findings related to the presence of invasive cancer after core biopsy.
Results
Fifty-one patients were diagnosed with DCIS after core biopsy. Of the 51 patients, 19 patients had invasive carcinoma diagnosed on final excision. The factors that correlated with invasion were the biopsy method, a palpable mass and a mammographic mass, regardless of calcification. A high nuclear grade, the comedo type, age, and the tumor size were not related to presence of invasive cancer.
Conclusion
A mass lesion on mammography, a palpable mass, and 14G core needle biopsy were significant predictors of invasion in patients with ductal carcinoma in situ. Surgeons always recognize the possibility of invasive cancer in patients with ductal carcinoma in situ on the core needle biopsy.
Table 1
Clinical characteristics
Table 2
Mammographic findings of the Final pathology*
Table 3
Histologic characteristics of the final pathology
References
-
Korea Central Cancer Registry. 2002 Annual report of the Korea Central Cancer Registry. Gwacheon: Ministry of Health and Welfare, Republic of Korea; 2003.
-
-
Emster VL, Ballard-Barbash R, Barlow WE, Zheng Y, Weaver DL, Cutter G, et al. Detection of ductal carcinoma in situ in women undergoing screening mammography. J Natl Cancer Inst 2002;94:1546–1554.
-
-
Fentiman IS. The dilemmaof in situ carcinoma of the breast. Int J Clin Pract 2001;55:680–683.
-
-
Yen TW, Hunt KK, Ross MI, Mirza NQ, Babiera GV, Meric-Bernstam F, et al. 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 2005;200:516–526.
-
-
Fisher ER, Costantino J, Fisher B, Palekar AS, Redmond C, Mamounas E. Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) Protocol B-17. Intraductal carcinoma (ductal carcinoma in situ). The National Surgical Adjuvant Breast and Bowel Project Collaborating Investigators. Cancer 1995;75:1310–1319.
-
-
Hoorntje LE, Schipper ME, Peeters PH, Bellot F, Storm RK, Borel Rinkes IH. The finding of invasive cancer after a preoperative diagnosis of ductal carcinoma-in-situ: causes of ductal carcinoma-in-situ underestimated with stereotactic 14-gauge needle biopsy. Ann Surg Oncol 2003;10:748–753.
-
-
Renshaw AA. Predicting invasion in the excision specimen from breast core needle biopsy specimens with only ductal carcinoma in situ. Arch Path Lab Med 2002;126:39–41.
-
-
Huo L, Sneige N, Hunt KK, Albarracin CT, Lopez A, Resetkova E. Predictors of invasion in patients with core-needle biopsy-diagnosed ductal carcinoma in situ and recommendations for a selective approach to sentinel lymph node biopsy in ductal carcinoma in situ. Cancer 2006;107:1760–1768.
-
-
King TA, Farr GH, Cederbom GJ, Smetherman DH, Bolton JS, Stolier AJ, et al. A mass on breast imaging predicts coexisting invasive carcinoma in patients with a core biopsy diagnosis of ductal carcinoma in situ. Am Surg 2001;67:907–912.
-