Contrast-Enhanced Mammographic Features of In Situ and Invasive Ductal Carcinoma Manifesting Microcalcifications Only: Help to Predict Underestimation?

Background: The contrast-enhanced mammographic features of ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) manifesting microcalcifications only on mammograms were evaluated to determine whether they could predict IDC underestimation. Methods: We reviewed patients who underwent mammography-guided biopsy on suspicious breast microcalcifications only and received contrast-enhanced spectral mammography (CESM) within 2 weeks before the biopsy. Those patients who were proven to have cancers (DCIS or IDC) by biopsy and subsequently had surgical treatment in our hospital were included for analysis. The presence or absence, size, morphology and texture of enhancement on contrast-enhanced spectral mammography were reviewed by consensus of two radiologists. Results: A total of 49 patients were included for analysis. Forty patients (81.6%) showed enhancement, including 18 (45%) DCIS and 22 (55%) IDC patients. All nine unenhanced cancers were pure DCIS. Pure DCIS showed 72.22% nonmass enhancement and 83.33% pure ground glass enhancement. IDC showed more mass (72.2% vs. 27.8%) and solid enhancements (83.33% vs. 16.67%). The cancer and texture of enhancement were significantly different between pure DCIS and IDC, with moderate diagnostic performance for the former (p-value < 0.01, AUC = 0.66, sensitivity = 93%, specificity = 39%) and the latter (p-value < 0.01, AUC = 0.74, sensitivity = 65%, specificity = 83%). Otherwise, pure DCIS showed a significant difference in enhanced texture compared with upgraded IDC and IDC (p = 0.0226 and 0.0018, respectively). Conclusions: Nonmass and pure ground glass enhancements were closely related to pure DCIS, and cases showing mass and unpurified solid enhancements should be suspected as IDC. Unenhanced DCIS with microcalcifications only has a low DCIS upgrade rate. The CESM-enhanced features could feasibly predict IDC underestimation.

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Contrast-enhanced Mammographic Features of In-situ and Invasive Ductal Carcinoma Manifesting Microcalcifications Only: Feasibility for Predicting Underestimation

10.21203/rs.3.rs-553792/v1 ◽

2021 ◽

Author(s):

Yun-chung Cheung ◽

Kueian Chen ◽

Chi-Chang Yu ◽

Shir-Hwa Ueng ◽

Chia-Wei Lee ◽

...

Keyword(s):

Invasive Ductal Carcinoma ◽

Carcinoma In Situ ◽

Breast Biopsy ◽

Ductal Carcinoma ◽

Ground Glass ◽

P Value ◽

Inclusion Criteria ◽

Contrast Enhanced ◽

Significant Difference

Abstract Background:The contrast-enhanced mammographic features of ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) manifesting microcalcifications only on mammograms were evaluated to determine whether they could predict DCIS underestimation.Methods:We reviewed the records of patients who underwent mammography-guided breast biopsy with vacuum-assisted core needle biopsy to enrol patients meeting the following inclusion criteria: (1) mammographic microcalcifications only; (2) contrast-enhanced spectral mammography within 2 weeks before biopsy; (3) mammography-guided biopsy-proven cancer (including DCIS and IDC); and (4) subsequent surgical treatment in our hospital. The presence or absence, size, morphology and texture of enhancement on contrast-enhanced spectral mammography were compared to determine any significant differences.Results:A total of 49 patients (27 DCIS, 22 IDC) were enrolled. Forty patients (81.6%) showed enhancement, including 18 (45%) DCIS and 22 (55%) IDC patients. All 9 unenhanced cancers were DCIS. DCIS showed 72.22% nonmass enhancement and 83.33% pure ground glass enhancement. IDC showed more mass (72.2% to 27.8%) and solid enhancements (83.33% to 16.67%). The cancer and texture of enhancement were significantly different, with moderate diagnostic performance for the former (p value <0.01, AUC= 0.66, sensitivity= 93%, specificity= 39%) and the latter (p value <0.01, AUC= 0.74, sensitivity= 0.65, specificity= 83%). DCIS showed a significant difference in enhanced texture compared with upgraded IDC and IDC (p=0.0226 and 0.0018, respectively).Conclusions:CESM-enhanced features can feasibly predict DCIS underestimation. Biopsy-proven DCIS without associated enhancement has a low DCIS upgrade rate.Nonmass and pure ground glass enhancements were closely related to DCIS, and cases showing mass and unpurified solid enhancements should be suspected as IDC.

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Clinicopathological predictors of postoperative upstaging to invasive ductal carcinoma (IDC) in patients preoperatively diagnosed with ductal carcinoma in situ (DCIS): a multi-institutional retrospective cohort study

Breast Cancer ◽

10.1007/s12282-021-01225-0 ◽

2021 ◽

Author(s):

Kiyo Tanaka ◽

Norikazu Masuda ◽

Naoki Hayashi ◽

Yasuaki Sagara ◽

Fumikata Hara ◽

...

Keyword(s):

Invasive Ductal Carcinoma ◽

Ductal Carcinoma In Situ ◽

Tumor Size ◽

Medical Records ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Palpable Mass ◽

Combined Use ◽

A Prospective Study

Abstract Background We conducted a prospective study with the intention to omit surgery for patients with ductal carcinoma in situ (DCIS) of the breast. We aimed to identify clinicopathological predictors of postoperative upstaging to invasive ductal carcinoma (IDC) in patients preoperatively diagnosed with DCIS. Patients and methods We retrospectively analyzed patients with DCIS diagnosed through biopsy between April 1, 2010 and December 31, 2014, from 16 institutions. Clinical, radiological, and histological variables were collected from medical records. Results We identified 2,293 patients diagnosed with DCIS through biopsy, including 1,663 DCIS (72.5%) cases and 630 IDC (27.5%) cases. In multivariate analysis, the presence of a palpable mass (odds ratio [OR] 1.8; 95% confidence interval [CI] 1.2–2.6), mammography findings (≥ category 4; OR 1.8; 95% CI 1.2–2.6), mass formations on ultrasonography (OR 1.8; 95% CI 1.2–2.5), and tumor size on MRI (> 20 mm; OR 1.7; 95% CI 1.2–2.4) were independent predictors of IDC. Among patients with a tumor size on MRI of ≤ 20 mm, the possibility of postoperative upstaging to IDC was 22.1%. Among the 258 patients with non-palpable mass, nuclear grade 1/2, and positive for estrogen receptor, the possibility was 18.1%, even if the upper limit of the tumor size on MRI was raised to ≤ 40 mm. Conclusion We identified four independent predictive factors of upstaging to IDC after surgery among patients with DCIS diagnosed by biopsy. The combined use of various predictors of IDC reduces the possibility of postoperative upstaging to IDC, even if the tumor size on MRI is larger than 20 mm.

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Trends in the surgical treatment of ductal carcinoma in situ of the breast

The American Journal of Surgery ◽

10.1016/s0002-9610(05)80652-x ◽

1992 ◽

Vol 164 (1) ◽

pp. 74-76 ◽

Cited By ~ 8

Author(s):

Elizabeth Ann Coleman ◽

Larry G. Kessler ◽

Lap-Ming Wun ◽

Eric J. Feuer

Keyword(s):

Surgical Treatment ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma

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Expression of MT-1 MMP, MMP2, MMP9 and TIMP2 mRNAs in Ductal Carcinoma in Situ and Invasive Ductal Carcinoma of the Breast

Yonsei Medical Journal ◽

10.3349/ymj.2006.47.3.333 ◽

2006 ◽

Vol 47 (3) ◽

pp. 333 ◽

Cited By ~ 32

Author(s):

Hee Jung Kim ◽

Chan-il Park ◽

Byeong Woo Park ◽

Hy-de Lee ◽

Woo Hee Jung

Keyword(s):

Invasive Ductal Carcinoma ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Carcinoma Of The Breast

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A Case Report: Lobular Carcinoma In Situ in a Male Patient with Subsequent Invasive Ductal Carcinoma Identified on Screening Breast MRI

Journal of Cancer ◽

10.7150/jca.4091 ◽

2012 ◽

Vol 3 ◽

pp. 226-230 ◽

Cited By ~ 8

Author(s):

Linda Kao ◽

Yekaterina Bulkin ◽

Susan Fineberg ◽

Leslie Montgomery ◽

Tova Koenigsberg

Keyword(s):

Case Report ◽

Invasive Ductal Carcinoma ◽

Male Patient ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

Breast Mri ◽

Lobular Carcinoma In Situ

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Ανοστοϊστοχημική εκτίμηση πρωτεϊνών οξείας φάσης σε διηθητικά καρκινώματα μαστού

10.12681/eadd/43283 ◽

2018 ◽

Author(s):

Διονύσιος Δήμας

Keyword(s):

Invasive Ductal Carcinoma ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Matched Pairs

Σκοπός της παρούσας μελέτης είναι η αξιολόγηση της σημασίας της έκφρασης των Hsp70/90 σε ασθενείς με καρκίνο μαστού. Σημαντική προέκταση της εκτίμησης αυτής αποτελεί η αξιολόγηση της σημασίας τους ως δυνητικά μόρια-στόχους στη φαρμακευτική θεραπεία του καρκίνου του μαστού.Μέθοδος: Προκειμένου για την αξιολόγηση της σχέσης αυτής πραγματοποιήθηκε μελέτη σε ιστικά δείγματα από 54 ασθενείς με πορογενή νεοπλάσματα του μαστού. Χρησιμοποιήθηκαν τα κατάλληλα αντιδραστήρια για τη μελέτη της έκφρασης των Hsp70/90 στα δείγματα αυτά, καθώς και της έκφρασης των ER, PR, HER2, Ki67. Παράλληλα εξετάστηκε, η διαφορά έκφρασης μεταξύ καρκινικών και μη ιστών, ο βαθμός ιστολογικής κακοήθειας, το μέγεθος του όγκου, η παρουσία ή μη λεμφαδενικής διήθησης από τον όγκο και η παρουσία απομακρυσμένων μεταστάσεων. Κατόπιν πραγματοποιήθηκε συστηματική ανασκόπηση της βιβλιογραφίας προκειμένου για τον έλεγχο της επίδρασης της έκφρασης των Hsp70/90 στην επιβίωση, το PCNALI, καθώς και στις μεταβλητές που εξετάστηκαν στην πρωτογενή μελέτη της παρούσας διατριβής. Επίσης πραγματοποιήθηκε ποσοτική σύνθεση (μετα-ανάλυση) των σχετικών αποτελεσμάτων των μελετών που περιλήφθηκαν στην ανασκόπηση.Αποτελέσματα: Από τις μεταβλητές που εξετάστηκαν στην πρωτογενή μελέτη δεν προέκυψε κάποια στατιστικά σημαντική συσχέτιση μεταξύ αυτών και της έκφρασης των Hsp70/90. Μόνη εξαίρεση αποτελεί η στατιστικά σημαντική, χαμηλότερη έκφραση της Hsp90 στο IDC (Invasive Ductal Carcinoma) σε σχέση με αυτή στο DCIS (Ductal Carcinoma in Situ) (DCIS (6.54±1.31 vs. 7.16±0.82, αντίστοιχα, p=0.004, Wilcoxon matched-pairs signed-ranks test) και αντίστοιχα, η σημαντικά χαμηλότερη έκφρασή της στο DCIS σε σχέση με αυτήν στο φυσιολογικό παρακείμενο μαστό (p=0.0002, με την ίδια δοκιμασία). Από την συστηματική ανασκόπηση της βιβλιογραφίας, τα μόνα σημεία στα οποία υπήρχε σύμπνοια των αποτελεσμάτων των μελετών, αφορούσαν στην έκφραση της Hsp70 σε σχέση με το PCNALI και στην σημαντικά χειρότερη συνολική επιβίωση των ασθενών με υψηλή έκφραση της Hsp90. Από τη μετα-ανάλυση προέκυψε συσχέτιση της υψηλής έκφρασης της Hsp90 με χειρότερη συνολική επιβίωση και οριακά χειρότερη ελεύθερη-νόσου επιβίωση των ασθενών με καρκίνο μαστού. Η υψηλή έκφραση της Hsp70 συσχετίστηκε επίσης με χειρότερη ελεύθερη-νόσου επιβίωση, καθώς και θετικότητα των οιστρογονικών (ER) και προγεστερονικών (PR) υποδοχέων.Συμπέρασμα: Από τη συστηματική ανασκόπηση και μετα-ανάλυση που πραγματοποιήθηκε στα πλαίσια της παρούσας διατριβής, υπογραμμίζεται η προγνωστική αξία της έκφρασης των Hsp70 και Hsp90 στον καρκίνο του μαστού. Περαιτέρω υψηλής ποιότητας μελέτες, με αναλυτική παρουσίαση των αποτελεσμάτων τους είναι αναγκαίες για την παροχή επιδημιολογικών στοιχείων, που θα συμπληρώσουν τα ευρήματα των εν εξελίξει κλινικών δοκιμών για τους αναστολείς των Hsps.

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