Factores predictivos de invasión en carcinoma ductal in situ diagnosticado por biopsia con aguja de corte

Abstract

Objective: To identify clinical, radiological, and histopathological characteristics that could be predictive factors of microinvasive/ invasive breast carcinoma in patients with diagnosis of ductal carcinoma in situ (DCIS) by core-needle biopsy. Material and methods: This is a retrospective study conducted from 2006-2017, which included women ≥18 years of age with initial DCIS, and who were treated with surgery. Final diagnosis was divided in DCIS and microinvasive/invasive carcinoma. Results: 334 patients were included: 193 (57.8%) with DCIS and 141 (42.2%) with microinvasive/invasive carcinoma (microinvasive 5.1%, invasive 37.1%). Lymph node metastasis occurred in 16.3%. Differences between DCIS and microinvasive/invasive groups included the presence of palpable nodule (36.7% vs. 63.2%), radiological nodule (29% vs. 51%), bigger radiological-tumor size (1.2 cm vs. 1.7 cm), and larger microcalcification extension (2.5 cm vs. 3.1 cm), all of these variables p ≤0.05. Hormonal receptors and HER2 expression were similar. After logistic regression analysis, predictive factor of invasion was the presence of palpable nodule (OR = 4.072, p <0.001) and radiological multicentric disease (OR = 1.677, 95%CI = 1.036-2.716, p = 0.035). Conclusions: In patients with DCIS, palpable nodule, and radiological multicentric disease, upgrade to microinvasive/invasive is high, and sentinel lymph node is recommended.

An ultrasound-based radiomics model to distinguish between sclerosing adenosis and invasive ductal carcinoma

“…A palpable mass with a lower radiomics score further suggests IDC. The results were basically consistent with previous research conclusions ( 1 , 29 , 30 ). In addition, based on the multivariate logistic regression analysis, the influence of confounding factors was eliminated, and the final three variables were obtained, including the radiomics score, BI-RADS and palpable mass, which were used as independent influence factors and were selected to develop the model.…”

Usefulness of immunohistochemical markers of myoepithelial cells in the diagnosis of invasive carcinoma of the breast

“…In the interesting article "Predictive factors of invasion in ductal carcinoma in situ diagnosed by coreneedle biopsy" 2 , the authors present a series of factors determining the risk of invasion for patients with ductal carcinoma in situ (DCIS), among which they evaluated the results of immunohistochemical studies for estrogen receptor markers, progestogen receptors, HER-2, and Ki-67 proliferation index, without finding a statistical association between the results of these studies and the risk of presenting invasive carcinoma. In this study, immunohistochemical staining for myoepithelial cells was not considered a determining factor for the disruption of intralobular stroma and the subsequent development of invasive carcinoma 2 .…”

Utilidad de los marcadores inmunohistoquímicos de células mioepiteliales en el diagnóstico de carcinoma invasor de la mama

“…En el interesante artículo «Factores predictivos de invasión en carcinoma ductal in situ diagnosticado por biopsia con aguja de corte» 2 , los autores presentan una serie de factores que determinan el riesgo de invasión para pacientes con carcinoma ductal in situ (CDIS), dentro de los cuales evaluaron los resultados de estudios de inmunohistoquímica para los marcadores de receptores de estrógeno, receptores de progestágeno, HER-2 e índice de proliferación Ki-67, sin encontrar una asociación estadística entre los resultados de estos estudios y el riesgo de presentar carcinoma invasor. En este estudio no se consideró la realización de marcación inmunohistoquímica para células mioepiteliales como factor determinante de la disrupción del estroma intralobulillar y el posterior desarrollo de carcinoma invasor 2 .…”