scholarly journals Profile of Digital Mammography Findings in Patients with Histopathologically Proven Ductal Carcinoma in Situ (DCIS)

2020 ◽  
Vol 27 (1) ◽  
pp. E202017
Author(s):  
Ankit Prabhakar ◽  
Dawood Iqbal Wani ◽  
Shivani Sharma ◽  
Sajjad Ahmad Dar ◽  
Shaafiya Ashraf
Keyword(s):  
Early Detection ◽  
Early Diagnosis ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Radiation Treatment ◽  
Ductal Carcinoma ◽  
Wide Spectrum ◽  
Histopathological Diagnosis ◽  
Number Of Patients

Breast carcinoma is a heterogeneous group of tumors with a wide spectrum of clinical presentations, lesion characterization and diagnostic evaluation. Ductal carcinoma in situ accounts for 15%-20% of breast carcinomas detected in screened populations. Ductal carcinoma in situ has a variable appearance on mammography. The use of mammography has become as a very helpful tool for the early detection of larger number of patients with ductal carcinoma in situ and, thus, offering timely surgery and the need for the appropriate radiation treatment to patients. This study was undertaken as a hospital-based retrospective study to evaluate the varied spectrum of mammographic findings in 57 women with histopathological diagnosis of ductal carcinoma in situ. The spectrum of mammographic findings of ductal carcinoma in situ was found to vary widely. A thorough and vigilant inspection of a mammogram is necessary for all the patients to avoid the possibility of missing early diagnosis of this entity, since the findings are very subtle. Most cases show microcalcifications on mammograms and their early detection can help in early diagnosis, thereby offering conservative surgical approach to a patient. Microcalcifications can be present isolated or in association with a mass. These are mostly clustered in distribution followed by regional, segmental and ductal pattern of distribution. The morphology of microcalcifications is mostly amorphous, followed by pleiomorphic and fine heterogenous types. Hence, the mammogram must be interpreted with strict vigilance and proper attention to all aspects for early and correct diagnosis of ductal carcinoma in situ to help in proper guidance of its treatment.

scholarly journals Stereotactic Vacuum-Assisted Breast Biopsy in Ductal Carcinoma in situ: Residual Microcalcifications and Intraoperative Findings

Breast Care ◽  
2019 ◽  
Vol 15 (4) ◽  
pp. 386-391
Author(s):  
Benedict Krischer ◽  
Serafino Forte ◽  
Gad Singer ◽  
Rahel A. Kubik-Huch ◽  
Cornelia Leo
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Significant Proportion ◽  
Invasive Cancer ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
High Grade ◽  
Surgical Specimen

Purpose: The question of overtreatment of ductal carcinoma in situ (DCIS) was raised because a significant proportion of especially low-grade DCIS lesions never progress to invasive cancer. The rationale for the present study was to analyze the value of stereotactic vacuum-assisted biopsy (VAB) for complete removal of DCIS, focusing on the relationship between the absence of residual microcalcifications after stereotactic VAB and the histopathological diagnosis of the definitive surgical specimen. Patients and Methods: Data of 58 consecutive patients diagnosed with DCIS by stereotactic VAB in a single breast center between 2012 and 2017 were analyzed. Patient records from the hospital information system were retrieved, and mammogram reports and images as well as histopathology reports were evaluated. The extent of microcalcifications before and after biopsy as well as the occurrence of DCIS in biopsy and definitive surgical specimens were analyzed and correlated. Results: There was no correlation between the absence of residual microcalcifications in the post-biopsy mammogram and the absence of residual DCIS in the final surgical specimen (p = 0.085). Upstaging to invasive cancer was recorded in 4 cases (13%) but occurred only in the group that had high-grade DCIS on biopsy. Low-grade DCIS was never upgraded to high-grade DCIS in the definitive specimen. Conclusions: The radiological absence of microcalcifications after stereotactic biopsy does not rule out residual DCIS in the final surgical specimen. Since upstaging to invasive cancer is seen in a substantial proportion of high-grade DCIS, the surgical excision of high-grade DCIS should remain the treatment of choice.

scholarly journals Is it necessary to remove intrapapillary ducts in therapeutic mammary adenectomies for breast cancer?

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Rebeca Neves Heinzen ◽  
Alfredo Carlos Simões Dornellas de Barros ◽  
Filomena Marino Carvalho ◽  
Cristiane da Costa Brandeia Abrahao Nimir ◽  
Alfredo Luiz Jacomo
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Glandular Tissue ◽  
Resonance Imaging ◽  
Areola Complex ◽  
Number Of Patients ◽  
Magnetic Resonance Imaging Mri

Introduction: The nipple-areola complex (NAC) has glandular tissue in intrapapillary ducts (IPDs). When the NAC is preserved during mammary adenectomies (MA) for the treatment of breast cancer (BC), this glandular tissue, which is a potential focus of tumor residues, remains. Objective: To estimate the frequency of neoplastic development in IPDs among BC patients treated with MA. Method: After the MA and with evidence of free retroareolar margin through intraoperative examination, the nipple was inverted, and its central portion, where mammary ducts are located, removed. A pointed-tip scalpel was used, preserving a tissue rim of 1.0 to 2.0 mm. The analysis involved 219 cases submitted to this type of surgery in the Clínica Professor Alfredo Barros. In all patients, the distance tumor-NAC was ≥2.0 cm, according to magnetic resonance imaging (MRI). The intrapapillary tissue removed was sent for microscopic examination of sections embedded in paraffin. Results: We found 4 cases of ductal carcinoma in situ (none infiltrating) in IPDs (1.19%). Considering only the 217 cases with free retroareolar margin in the definitive examination, the number of patients with ductal carcinoma in situ in IPDs decreased to 2 (0.9%). Conclusion: IPDs are rarely involved in selected cases of MA (distance tumor-NAC≥2.0 cm on MRI and free retroareolar margin). Ideally, they should be removed, especially when the intent is avoiding radiotherapy.

scholarly journals Genomic profiling reveals heterogeneous populations of ductal carcinoma in situ of the breast

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Satoi Nagasawa ◽  
Yuta Kuze ◽  
Ichiro Maeda ◽  
Yasuyuki Kojima ◽  
Ai Motoyoshi ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Epithelial To Mesenchymal Transition ◽  
Ductal Carcinoma ◽  
Sequencing Analysis ◽  
Mesenchymal Transition ◽  
Clinical Criteria ◽  
Whole Exome ◽  
Number Of Patients

AbstractIn a substantial number of patients, ductal carcinoma in situ (DCIS) of the breast will never progress to invasive ductal carcinoma, and these patients are often overtreated under the current clinical criteria. Although various candidate markers are available, relevant markers for delineating risk categories have not yet been established. In this study, we analyzed the clinical characteristics of 431 patients with DCIS and performed whole-exome sequencing analysis in a 21-patient discovery cohort and targeted deep sequencing analysis in a 72-patient validation cohort. We determined that age <45 years, HER2 amplification, and GATA3 mutation are possible indicators of relapse. PIK3CA mutation negativity and PgR negativity were also suggested to be risk factors. Spatial transcriptome analysis further revealed that GATA3 dysfunction upregulates epithelial-to-mesenchymal transition and angiogenesis, followed by PgR downregulation. These results reveal the existence of heterogeneous cell populations in DCIS and provide predictive markers for classifying DCIS and optimizing treatment.

scholarly journals Pure Ductal Carcinoma In Situ of the Breast: Analysis of 270 Consecutive Patients Treated in a 9-Year Period

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 431
Author(s):  
Corrado Chiappa ◽  
Alice Bonetti ◽  
Giulio Jad Jaber ◽  
Valentina De Berardinis ◽  
Veronica Bianchi ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Imaging Techniques ◽  
Clinical Stage ◽  
Lymph Node Biopsy ◽  
Final Pathology ◽  
Number Of Patients ◽  
Age Of Diagnosis

Introduction: Ductal carcinoma in situ (DCIS) is an intraductal neoplastic proliferation of epithelial cells that are confined within the basement membrane of the breast ductal system. This retrospective observational analysis aims at reviewing the issues of this histological type of cancer. Materials and methods: Patients treated for DCIS between 1 January 2009 and 31 December 2018 were identified from a retrospective database. The patients were divided into two groups of 5 years each, the first group including patients treated from 2009 to 2013, and the second group including patients treated from 2014 to 2018. Once the database was completed, we performed a statistical analysis to see if there were significant differences among the 2 periods. Statistical analyses were performed using GraphPad Prism software for Windows, and the level of significance was set at p < 0.05. Results: 3586 female patients were treated for breast cancer over the 9-year study period (1469 patients from 2009 to 2013 and 2117 from 2014 to 2018), of which 270 (7.53%) had pure DCIS in the final pathology. The median age of diagnosis was 59-year-old (range 36–86). In the first period, 81 (5.5%) women out of 1469 had DCIS in the final pathology, in the second, 189 (8.9%) out of 2117 had DCIS in the final pathology with a statistically significant increase (p = 0.0001). From 2009 to 2013, only 38 (46.9%) were in stage 0 (correct DCIS diagnosis) while in the second period, 125 (66.1%) were included in this stage. The number of patients included in clinical stage 0 increased significantly (p = 0.004). In the first period, 48 (59.3%) specimen margins were at a greater or equal distance than 2 mm (negative margins), between 2014 and 2018; 137 (72.5%) had negative margins. Between 2014 and 2018 the number of DCIS patients with positive margins decreased significantly (p = 0.02) compared to the first period examined. The mastectomies number increased significantly (p = 0.008) between the 2 periods, while the sentinel lymph node biopsy (SLNB) numbers had no differences (p = 0.29). For both periods analysed all the 253 patients who underwent the follow up are currently living and free of disease. We have conventionally excluded the 17 patients whose data were lost. Conclusion: The choice of the newest imaging techniques and the most suitable biopsy method allows a better pre-operative diagnosis of the DCIS. Surgical treatment must be targeted to the patient and a multidisciplinary approach discussed in the Breast Unit centres.

scholarly journals Label-Free Identification of Early Stages of Breast Ductal Carcinoma via Multiphoton Microscopy

Scanning ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Zhong Chen ◽  
Wenhui Guo ◽  
Deyong Kang ◽  
Shu Wang ◽  
Liqin Zheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Diagnosis ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Multiphoton Microscopy ◽  
Label Free ◽  
Early Stages ◽  
Cytological Features

Breast cancer can be cured by early diagnosis. Appropriate and effective clinical treatment benefits from accurate pathological diagnosis. However, due to the lack of effective screening and diagnostic imaging methods, early stages of breast cancer often progress to malignant breast cancer. In this study, multiphoton microscopy (MPM) via two-photon excited fluorescence combined with second-harmonic generation was used for identifying the early stages of breast ductal carcinoma. The results showed differences in both cytological features and collagen distribution among normal breast tissue, atypical ductal hyperplasia, low-grade ductal carcinoma in situ, and high-grade ductal carcinoma in situ with microinvasion. Furthermore, three features extracted from the MPM images were used to describe differences in cytological features, collagen density, and basement membrane circumference in the early stages of breast ductal carcinoma. They revealed that MPM has the ability to identify early stages of breast ductal carcinoma label-free, which would contribute to the early diagnosis and treatment of breast cancer. This study may provide the groundwork for the further application of MPM in the clinic.

scholarly journals Unusual mammography findings of patients with ductal carcinoma in situ (DCIS) of the breast.

2008 ◽  
Vol 12 (4) ◽  
pp. 97
Author(s):  
F Ismail ◽  
J Holl ◽  
Z Lockhat ◽  
H Akande
Keyword(s):  
Early Detection ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Pathological Diagnosis ◽  
Single View ◽  
Multifocal Disease

Abstract The early detection of carcinoma is the highlight of mammography. We present two patients with pathological diagnosis of DCIS with unusual mammographic findings for which one needs to have a higher index of suspicion. The first patient presented with multifocal disease requiring biopsy of all visible lesions and the second patient (twenty four years old) presented with segmental distribution of calcifications, which may have been missed had a single-view baseline mammogram not been done.

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