Clinical Outcome after Selective Treatment of Patients Diagnosed with Ductal Carcinoma In Situ of the Breast

Meijnen, Philip; Oldenburg, Hester S. A.; Peterse, Johannes L.; Bartelink, Harry; Rutgers, Emiel J.

doi:10.1245/s10434-007-9659-2

Cited by 84 publications

(63 citation statements)

References 20 publications

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“…More important, the risk of LRR for patients with close margins was lower than the risk of development of contralateral breast cancer (6.4 %). The rate of contralateral breast cancer development is essentially the same as the rate reported by Meijnen et al 9 for patients with DCIS treated with mastectomy: 6.5 % over 8 years. Further, Kim et al 21 reported that 90 % of patients treated with mastectomy for DCIS who developed a LRR were successfully treated with excision and radiotherapy.…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Incidence and Consequence of Close Margins in Patients with Ductal Carcinoma-In Situ Treated with Mastectomy: Is Further Therapy Warranted?

Sarma¹,

Hwang²

2014

Breast Diseases: A Year Book Quarterly

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Section: Discussionsupporting

confidence: 81%

“…[3][4][5] The local regional recurrence (LRR) rate for DCIS treated with mastectomy is not zero and is reported to be 0.8-3.3 %. [6][7][8][9][10] Several studies have evaluated potential predictors of LRR after mastectomy for DCIS in an attempt to improve the already low rates of LRR. [11][12][13][14][15][16] One of these potential predictors is margin status.…”

mentioning

confidence: 99%

Incidence and Consequence of Close Margins in Patients with Ductal Carcinoma-In Situ Treated with Mastectomy: Is Further Therapy Warranted?

Sarma¹,

Hwang²

2014

Breast Diseases: A Year Book Quarterly

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“…In the United States, the overall mastectomy rate decreased from 43% in 1992 to 37% in 1995 and 28% in 1999 Baxter et al, 2004;Mokbel and Cutuli, 2006). However, this rate was much higher (58%) in a large series from the Netherlands Cancer Institute (Meijnen et al, 2008). Tumour Table 3 Influence of tumour size, nuclear grade, necrosis and age on treatment modality (number and percent patients) (Fisher et al, 2001;Solin et al, 2001;Cutuli et al, 2002;Fourquet et al, 2002;Vicini and Recht, 2002;Bijker et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Breast-conserving surgery with or without radiotherapy vs mastectomy for ductal carcinoma in situ: French Survey experience

et al. 2009

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physicians throughout France prospectively recruited 1289 ductal carcinoma in situ (DCIS) patients and collected data on diagnosis, patient and tumour characteristics, and treatments. Median age was 56 years (range, 30 -84). Ductal carcinoma in situ was diagnosed by mammography in 87.6% of patients. Mastectomy, conservative surgery alone (CS) and CS with radiotherapy (CS þ RT) were performed in 30.5, 7.8 and 61.7% of patients, respectively. Thus, 89% of patients treated by CS received adjuvant RT. Sentinel node biopsy (SNB) and axillary dissection (AD) were performed in 21.3 and 10.4% of patients, respectively. Hormone therapy was administered to 13.4% of the patients (80% tamoxifen). Median tumour size was 14.5 mm (6, 11 and 35 mm for CS, CS þ RT and mastectomy, respectively, Po0.0001). Nuclear grade was high in 21% of patients, intermediate in 38.5% and low in 40.5%. Excision was considered complete in 92% (CS) and 88.3% (CS þ RT) of patients. Oestrogen receptors were positive in 69.8% of assessed cases (31%). Treatment modalities varied widely according to region: mastectomy rate, 20 -37%; adjuvant RT, 84 -96%; hormone treatment, 6 -34%. Our survey on current DCIS management in France has highlighted correlations between pathological features (tumour size, margin and grade) and treatment options, with several similar variations to those observed in recent UK and US studies.

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“…(7) It was found the mean size of DCIS of 1.4 to 2.7 cm, (4) 3.5 cm (8) and 3.7 cm (9) (measured pathologically), 1 to 1.5cm (10) and 2.56 cm. (11) Our study reports a tumor which size is greater than two times of the majority of the descriptions.…”

Section: Discussionmentioning

confidence: 98%

“…(1) The main cancer to affect Brazilian women is non-melanoma skin cancer (71.000 new cases), followed in order of frequency by malignant neoplasms of the breast (53.000), cervix uteri (18.000), colon/rectum (16.000) and lung (10.000). (1) Clinical presentation of pure Ductal Carcinoma in Situ (DCIS) is often described as extension small tumors (4)(5)(6)(7)(8)(9)(10)(11) detected mainly by mammography. Recognizing this type of tumor may manifest as palpable lesion, it is necessary to know and to apply methods that allow diagnosis early: self-breast examination, and clinical examination by a trained team.…”

Section: Introductionmentioning

confidence: 99%

Ductal Carcinoma in Situ of the Breast: A Case Report With an Atypical Clinical Presentation

Campodonio

Oliveira

Machado

2013

BJMHH

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Ductal carcinoma in situ (DCIS) of the breast is a proliferative lesion, precursor of cancer, which has been increasingly diagnosed due to mammographic screening. Tumor size itself does not determine whether the lesion is in situ or invasive, so it is essential to emphasize that DCIS can present with variable extension. We report a case of a 44-year-old female patient that was diagnosed a great (12 cm) DCIS of the breast without microinvasion through pathologic examination. The patient presented with an increase of the right breast, acyclic mastalgia and right bloody nipple discharge. Mammography was inconclusive, the ultrasound suggested inflammation and the incisional biopsy revealed DCIS nuclear grade 3 with compromised lateral margins. It was performed simple mastectomy and axillary node sampling. The clinical presentations of benign and malignant diseases of the breast are variable. The most common symptoms reported by women are pain, palpable mass or nipple discharge. The literature reveals that the extent of this type of cancer is variable, being found in a review intraductal lesions up to 5.4 cm, size smaller than that one that was found in this patient. This finding makes the clinical apresentation interesting to be discussed. Although mammography is the most efficient method to diagnose this injury, clinical breast exam should be performed in all gynecological independent of patient age because it is useful for diagnosing early lesion, considering that it is a palpable lesion.Keywords: Breast cancer; Clinical presentation; Diagnosis. INTRODUCTIONBreast cancer is a common disease among women and in recent decades, has been noticing an increase in incidence and mortality associated with this neoplasm. (1,2,3) According to the Ministry of Health (2012), (1) even being considered as a good prognosis cancer when diagnosed and treated appropriately, mortality from breast cancer still present with high rates in Brazil, probably by the diagnosis in advanced stages (III or IV). The DCIS of the breast involves a heterogeneous group of neoplastic proliferation, non-invasive, with risk of recurrence and malignant transformation. (16) According to Boff and Wisintainer (2006), (17) the increase in the incidence of DCIS is due to mammographic imaging technology that is diagnosing non-palpable breast lesions. They claim that the diagnosis and treatment of non-invasive breast cancer will reduce the mortality rate in up to 46%. In patients adequately treated, the survival rate in 16 years is 95%. (18) DCIS does not invade the lymphatics and blood vessels, therefore, can not spread. It is composed of a population of malignant cells confined to the ducts by the basement membrane. It is therefore a clonal proliferation involving, in general, a single ductal system and the myoepithelial cells are preserved. (19,20) But, may be involved more than one duct or a single duct with more than one target area, separated by parenchyma without lesions. (21) This work aimed to report a case of DCIS of the breast in extensive...

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Clinical Outcome after Selective Treatment of Patients Diagnosed with Ductal Carcinoma In Situ of the Breast

Cited by 84 publications

References 20 publications

Incidence and Consequence of Close Margins in Patients with Ductal Carcinoma-In Situ Treated with Mastectomy: Is Further Therapy Warranted?

Incidence and Consequence of Close Margins in Patients with Ductal Carcinoma-In Situ Treated with Mastectomy: Is Further Therapy Warranted?

Breast-conserving surgery with or without radiotherapy vs mastectomy for ductal carcinoma in situ: French Survey experience

Ductal Carcinoma in Situ of the Breast: A Case Report With an Atypical Clinical Presentation

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