J Korean Surg Soc.  2011 Feb;80(2):90-95. 10.4174/jkss.2011.80.2.90.

Risk Factor of Invasive Breast Cancer in Patients with Preoperative Diagnosis of Ductal Carcinoma in Situ

• Shin SH
• Kim BC
• Song YJ
• Yoon HC
• Cho JS
• Park MH
• Yoon JH
• Jegal YJ

• KMID: 2117115
• DOI: http://doi.org/10.4174/jkss.2011.80.2.90

Abstract

PURPOSE
Ductal carcinoma in situ (DCIS), unlike invasive ductal carcinoma, does not require sentinel lymph node biopsy or axillary lymph node dissection because the possibility of axillary lymph node metastasis is low. However, occasionally, despite preoperative diagnosis of DCIS, invasive ductal carcinoma can be diagnosed by postoperative biopsy. Therefore, a study of the associated risk factors is necessary.
METHODS
198 patients with an initial diagnosis of DCIS, treated between February 2005 and December 2009, were retrospectively analyzed. Associations between clinical and pathologic factors were analyzed for significance using univariate and multivariate analyses.
RESULTS
Of the 198 patients, 57 (28.8%) were found to have invasive disease on final pathology. Multivariate analysis revealed 4 independent predictors of invasive cancer upon final pathology: diagnosis by needle biopsy (OR, 3.165; P=0.008), positive p53 on preoperative biopsy (OR, 2.494; P=0.019) DCIS size (>2 cm) on microscopic finding (OR, 2.683; P=0.014), and relatively young age (OR, 0.958, P=0.046). Of the 13 patients with positive axillary lymph nodes, 11 (84.6%) were shown to have invasive cancer on final pathology (P<0.001).
CONCLUSION
In cases of preoperative diagnosis based on needle biopsy, positive p53, large tumor, and relatively young age, an SLNB procedure can be considered because in almost 30% of the patients an invasive carcinoma is found after surgery.

Keyword

Ductal carcinoma in situ; Invasive breast cancer

MeSH Terms

Biopsy
Biopsy, Needle
Breast
Breast Neoplasms
Carcinoma, Ductal
Carcinoma, Intraductal, Noninfiltrating
Humans
Lymph Node Excision
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Nitriles
Pyrethrins
Retrospective Studies
Risk Factors
Sentinel Lymph Node Biopsy
Nitriles
Pyrethrins

Reference

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