J Korean Surg Soc.  2003 Apr;64(4):289-295.

Ductal Carcinoma In Situ (DCIS) of the Breast; Clinico-pathological Analysis, Expression of Molecular Markers, and Correlations between Known Prognostic Factors

• Kang SS
• Ko SS
• Jo BH
• Hur MH
• Lee HK
• Lee SK
• Chun YK
• Kim YJ
• Lee KS
• Hong SR
• Lee JH

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.

Keyword

Breast cancer; Ductal carcinoma in situ (DCIS); Molecular markers

MeSH Terms

Breast Neoplasms
Breast*
Carcinoma, Ductal*
Carcinoma, Intraductal, Noninfiltrating*
Diagnosis
Female
Follow-Up Studies
Humans
Immunohistochemistry
Lymph Nodes
Mammography
Mass Screening
Mortality
Prevalence
Recurrence