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KMID : 0371320030640040289
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Journal of the Korean Surgical Society
2003 Volume.64 No. 4 p.289 ~ p.295
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Ductal Carcinoma In Situ (DCIS) of the Breast; Clinico-pathological Analysis, Expression of Molecular Markers, and Correlations between Known Prognostic Factors
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Kang Sung-Soo
Ko Seung-Sang
Cho Back-Hyun
Hur Min-Hee
Lee Hae-Kyung
Lee Sung-Kong
Chun Yee-Kyung
Kim Yee-Jeong
Lee Kyung-Sang
Hong Sung-Ran
Lee Jee-Hyun
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Abstract
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PURPOSE: The improved availability of breast cancer screening, including mammography, has dramatically increased the detection rate of DCIS (ductal carcinoma in situ). However, there has been controversy regarding the clinico-pathological
characteristics and optimal management of DCIS. This analysis was conducted in order to evaluate the clinico-pathological findings of DCIS, and any possible correlations between the known prognostic factors.
METHODS: We analyzed 58 consecutive cases of DCIS, from 1990 to 1995, including data on the annual proportion of DCIS to total breast cancer cases, the clinico-pathological characteristics and the expressions of ER, PR, c-erbB-2 and p53. The median length of follow-up was 98.5 months.
RESULTS: The proportion of DCIS was 8.8%, with progressive increases from 1990 to 1995. The mean age at diagnosis was 47.1 years, with the peak of prevalence seen in women aged 40~49 years. The most common presentation was a palpable breast mass in 28 (48.3%) cases, but 18 (31%) patients were asymptomatic. The mammographic findings demonstrated calcification in 75% and mass density in 59.6%. There was only 1 (1.8%) case of a bilateral lesion, and 5 (8.6%) of multifocal or multicentric lesions. Axillary lymph nodes were positive in 5.5% of the patients who underwent an axillary dissection. Breast conserving operations were performed in 8 (13.8%) cases. The frequencies of ER, PR, c-erbB-2 and p53, positivity, by immunohistochemistry were 52, 50, 55.1 and 30.6%, respectively. c-erbB-2 immunoreactivity was found more often in DCIS with larger size, higher nuclear grade and negative ER and PR (P=0.011, P=0.001, P=0.002, and P=0.006, respectively). There was a significant association between higher nuclear grade and negative ER and PR, and comedotype (P=0.001, P=0.000, and 0.008, respectively). Although an invasive ductal carcinoma had developed in 5.4% of the contralateral breasts, there were no cases of systemic relapse, or disease-specific mortality, at the last follow-up.
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KEYWORD
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Breast cancer, Ductal carcinoma in situ (DCIS), Molecular markers
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