Clinicopathologic, mammographic, and sonographic features in 1,187 patients with pure ductal carcinoma in situ of the breast by estrogen receptor status

Abstract

Background The clinicopathologic, mammographic, and sonographic findings in patients with pure ductal carcinoma in situ (DCIS) were assessed by estrogen receptor (ER) expression. Methods After institutional review board approval, patients with pure DCIS evaluated from January 1996 to July 2009 with known ER status and available imaging were identified. Images were reviewed per the ACR BI-RADS® lexicon (4th edition). Clinical, pathologic, and imaging characteristics were analyzed by ER status using t-test, chi-square test, and Fisher’s exact test. Results Of 1219 patients with pure DCIS and known ER status identified, 1187 with complete data were included. Mammography was performed in all 1187 patients and sonography in 519 (44%). There were 972 (82%) patients with ER-positive and 215 (18%) with ER-negative disease. ER-negative DCIS was more likely to be high grade (93% vs 44%, p<0.0001), associated with comedonecrosis (64% vs 29%, p<0.0001), and multifocal (23% vs 15%, p=0.009). On sonography, ER-negative DCIS was more likely to be visible (61% vs 46%, p=0.004), larger (mean size, 2.3 vs 1.6 cm, p=0.006), and show posterior shadowing (53% vs 28%, p=0.006). Mastectomy was more frequently performed for ER-negative DCIS (47% vs 37%, p=0.008). Palpable DCIS was visible on sonography in 55% of cases and mammography in 81%. Compared with ER-positive palpable DCIS, ER-negative palpable DCIS was larger and more likely to be visible on sonography. Compared with ER-positive noncalcified DCIS, ER-negative noncalcified DCIS was less likely to be visible on mammography. Conclusion ER-positive and ER-negative pure DCIS have different clinicopathologic and imaging characteristics. ER-negative DCIS is associated with worse prognostic factors then ER-positive DCIS. On sonography, ER-negative DCIS is more frequently visible than ER-positive DCIS, tends to be larger, and more frequently demonstrates posterior shadowing.

Microcalcifications in 1657 Patients with Pure Ductal Carcinoma in Situ of the Breast: Correlation with Clinical, Histopathologic, Biologic Features, and Local Recurrence

“…40–42 There was no significant association between imaging features of microcalcifications and ER status; however, ER-negative pure DCIS was associated with high nuclear grade, comedonecrosis, and older age. 25 Therefore, ER-negative pure DCIS is more likely to be aggressive; this needs to be taken into consideration when management options are selected, especially in older women.…”

“…This is an expansion of our previous study 25 that included only patients with known ER status; in the current study, we included 692 additional patients who did not have ER status determined.…”

Morphopathological and immunohistochemical features of a pure mucinous breast carcinoma – Case report

“…In present case, it was also obtained a positive results for hormonal receptor both in the mucinous and in the IDC-NST component consisted with literature reports. The absence of ER and PR expression in the in situ component wasn't surprising because it had been demonstrated that highgrade DCIS, especialy comedo-type has a negative ER and PR imunostain [25,26,27]. Both biomarkers have a predictive role since patients with a positive imunostain receive treatment with trastuzumab [28].…”

Will Supplemental Screening Ultrasound Increase Breast Cancer Overdiagnosis?

“…Whether additional DCIS cases detected only with US would be clinically important remains to be seen. Although US can certainly detect both high-and low-grade DCIS (16,17), there is very little data regarding the characteristics of DCIS detected with US alone. Of the US-only-detected cancers in the ACRIN study, only 6.2% were noninvasive.…”