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Preoperatively diagnosed ductal cancers in situ of the breast presenting as even small masses are of high risk for the invasive cancer foci in postoperative specimen.
World J Surg Oncol. 2015 Jul 16; 13:218.WJ

Abstract

BACKGROUND

In ductal carcinoma in situ of the breast (DCIS), histologic diagnosis obtained before the definitive treatment is related to the risk of underestimation if the presence of invasive cancer is found postoperatively. These patients need a second operation to assess the nodal status. We evaluated the upstaging rate in patients with mass-forming DCIS.

METHODS

Sixty-three women with pure DCIS presenting as sonographic mass lesion underwent vacuum-assisted or core-needle biopsy and subsequent surgery. Rates of postoperative upstaging to invasive cancer were calculated and compared with clinical character and size of DCIS.

RESULTS

Median age of patients (range) was 63 years (27-88) while median diameter of DCIS was 11 mm (6-60). Fifty-six percent of DCIS were upstaged. Patient age did not differ significantly between groups with and without final invasion (median, mean, SD): 63, 61.4, 12.5 vs 62, 61.2, 10.6 years, respectively (P=0.659). The difference of DCIS size between these groups was statistically important (median, mean, SD): 13, 17.3, 11.4 vs 9.5, 9.8, 3.2 mm, respectively (P=0.0003). Mass size and palpability were significant risk factors (P<0.001 and P<0.01, respectively). Rate of underestimation for mass with diameter≤10 mm, 10-20 mm and >20 mm was 37, 64 and 91%, respectively.

CONCLUSIONS

DCIS diagnosed on minimal-invasive biopsy of even small sonographic mass is of high risk for the upstaging to invasive cancer after final surgical excision. In these patients, subsequent intervention is needed for nodal status assessment. They are good candidates for the sentinel node biopsy during the breast operation to avoid multi-step surgery.

Authors+Show Affiliations

Department of Surgical Oncology, Lower Silesian Oncology Centre, Plac Hirszfelda 12, 53-413, Wroclaw, Poland. szynglarewicz.b@dco.com.pl.Department of Breast Imaging, Lower Silesian Oncology Centre, Wroclaw, Poland.Department of Pathology, Wroclaw Medical University, Wroclaw, Poland.Department of Surgical Oncology, Lower Silesian Oncology Centre, Plac Hirszfelda 12, 53-413, Wroclaw, Poland. Department of Oncology, Wroclaw Medical University, Wroclaw, Poland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26179898

Citation

Szynglarewicz, Bartlomiej, et al. "Preoperatively Diagnosed Ductal Cancers in Situ of the Breast Presenting as Even Small Masses Are of High Risk for the Invasive Cancer Foci in Postoperative Specimen." World Journal of Surgical Oncology, vol. 13, 2015, p. 218.
Szynglarewicz B, Kasprzak P, Halon A, et al. Preoperatively diagnosed ductal cancers in situ of the breast presenting as even small masses are of high risk for the invasive cancer foci in postoperative specimen. World J Surg Oncol. 2015;13:218.
Szynglarewicz, B., Kasprzak, P., Halon, A., & Matkowski, R. (2015). Preoperatively diagnosed ductal cancers in situ of the breast presenting as even small masses are of high risk for the invasive cancer foci in postoperative specimen. World Journal of Surgical Oncology, 13, 218. https://doi.org/10.1186/s12957-015-0641-3
Szynglarewicz B, et al. Preoperatively Diagnosed Ductal Cancers in Situ of the Breast Presenting as Even Small Masses Are of High Risk for the Invasive Cancer Foci in Postoperative Specimen. World J Surg Oncol. 2015 Jul 16;13:218. PubMed PMID: 26179898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preoperatively diagnosed ductal cancers in situ of the breast presenting as even small masses are of high risk for the invasive cancer foci in postoperative specimen. AU - Szynglarewicz,Bartlomiej, AU - Kasprzak,Piotr, AU - Halon,Agnieszka, AU - Matkowski,Rafal, Y1 - 2015/07/16/ PY - 2015/04/29/received PY - 2015/07/03/accepted PY - 2015/7/17/entrez PY - 2015/7/17/pubmed PY - 2016/4/27/medline SP - 218 EP - 218 JF - World journal of surgical oncology JO - World J Surg Oncol VL - 13 N2 - BACKGROUND: In ductal carcinoma in situ of the breast (DCIS), histologic diagnosis obtained before the definitive treatment is related to the risk of underestimation if the presence of invasive cancer is found postoperatively. These patients need a second operation to assess the nodal status. We evaluated the upstaging rate in patients with mass-forming DCIS. METHODS: Sixty-three women with pure DCIS presenting as sonographic mass lesion underwent vacuum-assisted or core-needle biopsy and subsequent surgery. Rates of postoperative upstaging to invasive cancer were calculated and compared with clinical character and size of DCIS. RESULTS: Median age of patients (range) was 63 years (27-88) while median diameter of DCIS was 11 mm (6-60). Fifty-six percent of DCIS were upstaged. Patient age did not differ significantly between groups with and without final invasion (median, mean, SD): 63, 61.4, 12.5 vs 62, 61.2, 10.6 years, respectively (P=0.659). The difference of DCIS size between these groups was statistically important (median, mean, SD): 13, 17.3, 11.4 vs 9.5, 9.8, 3.2 mm, respectively (P=0.0003). Mass size and palpability were significant risk factors (P<0.001 and P<0.01, respectively). Rate of underestimation for mass with diameter≤10 mm, 10-20 mm and >20 mm was 37, 64 and 91%, respectively. CONCLUSIONS: DCIS diagnosed on minimal-invasive biopsy of even small sonographic mass is of high risk for the upstaging to invasive cancer after final surgical excision. In these patients, subsequent intervention is needed for nodal status assessment. They are good candidates for the sentinel node biopsy during the breast operation to avoid multi-step surgery. SN - 1477-7819 UR - https://www.unboundmedicine.com/medline/citation/26179898/Preoperatively_diagnosed_ductal_cancers_in_situ_of_the_breast_presenting_as_even_small_masses_are_of_high_risk_for_the_invasive_cancer_foci_in_postoperative_specimen_ DB - PRIME DP - Unbound Medicine ER -