Ductal Carcinoma-In-Situ: Long-Term Results of Breast-Conserving Therapy

Mirza, Nadeem Q.; Vlastos, Georges; Meric, Funda; Şahin, Ayşegül; Singletary, S. Eva; Newman, Lisa A.; Kuerer, Henry Mark; Ames, Frederick C.; Ross, Merrick I.; Feig, Barry W.; Pollock, Raphael E.; Buchholz, Thomas A.; McNeese, Marsha D.; Strom, Eric A.; Hortobágyi, Gabriel N.; Hunt, Kelly K.

doi:10.1007/s10434-000-0656-y

Cited by 37 publications

(18 citation statements)

References 48 publications

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“…Silverstein (2003) noted that DCIS is a heterogeneous group of lesions, and thus a uniform treatment policy is inappropriate, as different patients will require or benefit from different treatment options (Silverstein, 2003). In a review of 21 studies involving DCIS patients who were treated by mastectomy, a 0.4% incidence of recurrence was observed (Lagios et al, 1989;Boyages et al, 1999;Silverstein et al, 1999;Mirza et al, 2000). Significantly lower local recurrence rates after a total mastectomy compared to corresponding rates after BCS were confirmed by Cutuli et al (2001), who reported local recurrence rates of 2.1%, 30.1%, and 13.8% in the mastectomy, BCS alone, and BCS with RT patient groups, respectively, after a 91 month follow-up period (Cutuli et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Ozkan-Gurdal¹,

Cabıoğlu²,

Özçınar³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Whether sentinel lymph node biopsy (SLNB) should be performed in patients with pure ductal carcinoma in situ (DCIS) of the breast has been a question of debate over the last decade. The aim of this study was to identify factors associated with microinvasive disease and determine the criteria for performing SLNB in patients with DCIS. Materials and Methods: 125 patients with DCIS who underwent surgery between January 2000 and December 2008 were reviewed to identify factors associated with DCIS and DCIS with microinvasion (DCISM). Results: 88 patients (70.4%) had pure DCIS and 37 (29.6%) had DCISM. Among 33 DCIS patients who underwent SLNB, one patient (3.3%) was found to have isolated tumor cells in her biopsy, whereas 1 of 14 (37.8%) patients with DCISM had micrometastasis (7.1%). Similarly, of 16 patients (18.2%) with pure DCIS and axillary lymph node dissection (ALND) without SLNB, none had lymph node metastasis. Furthermore, of 20 patients with DCISM and ALND, only one (5%) had metastasis. In multivariate analysis, the presence of comedo necrosis [relative risk (RR)=4.1, 95% confidence interval (CI)=1.6-10.6, P=0.004], and hormone receptor (ER or PR) negativity (RR=4.0, 95%CI=1.5-11, P=0.007), were found to be significantly associated with microinvasion. Conclusions: Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with comedo necrosis or hormone receptor negativity are more likely to have a microinvasive component in definitive pathology following surgery, and should be considered for SLNB procedure along with patients who will undergo mastectomy due to DCIS.

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Section: Discussionmentioning

confidence: 99%

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Ozkan-Gurdal¹,

Cabıoğlu²,

Özçınar³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…There are two currently-held concepts that meet with general agreement on this topic: the first is the evidence that wide surgical excision and negative margins of resection decrease the risk of LR in patients with mammographically-detected DIN treated with BCS and radiation [26]. The second concept is a general consensus that patients with positive margins show a significantly higher rate of LR than do patients with negative margins, regardless of irradiation or tamoxifen administration [27][28].…”

Section: Surgical Treatmentmentioning

confidence: 99%

The management of ductal intraepithelial neoplasia (DIN): open controversies and guidelines of the Istituto Europeo di Oncologia (IEO), Milan, Italy

Farante

Zurrida

Galimberti

et al. 2010

Breast Cancer Res Treat

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“…Particularly, the greatest potential clinical impact could be intraoperative detection of DCIS, which has a very important status in breast pathology because its presence is a powerful predictor for local disease reoccurrence and its identification during surgery influences treatment options. [51][52][53][54] DCIS is a nonpalpable lesion, unidentifiable during surgery; consequently, characterization of its spectral response could dramatically improve patient care. Finally, understanding the relationship between the optical and biological properties of a tissue will ultimately improve the diagnostic utility of optical techniques, permitting optimization of the measurement procedure and signal analysis for enhanced sensitivity to differentiating features.…”

Section: Discussionmentioning

confidence: 99%

Automated classification of breast pathology using local measures of broadband reflectance

et al. 2010

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Abstract. We demonstrate that morphological features pertinent to a tissue's pathology may be ascertained from localized measures of broadband reflectance, with a mesoscopic resolution (100-μm lateral spot size) that permits scanning of an entire margin for residual disease. The technical aspects and optimization of a k-nearest neighbor classifier for automated diagnosis of pathologies are presented, and its efficacy is validated in 29 breast tissue specimens. When discriminating between benign and malignant pathologies, a sensitivity and specificity of 91 and 77% was achieved. Furthermore, detailed subtissue-type analysis was performed to consider how diverse pathologies influence scattering response and overall classification efficacy. The increased sensitivity of this technique may render it useful to guide the surgeon or pathologist where to sample pathology for microscopic assessment. C 2010 Society of Photo-Optical Instrumentation Engineers.

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Ductal Carcinoma-In-Situ: Long-Term Results of Breast-Conserving Therapy

Cited by 37 publications

References 48 publications

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Factors Predicting Microinvasion in Ductal Carcinoma in situ

The management of ductal intraepithelial neoplasia (DIN): open controversies and guidelines of the Istituto Europeo di Oncologia (IEO), Milan, Italy

Automated classification of breast pathology using local measures of broadband reflectance

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