scholarly journals Questioning the Value of Evaluating Estrogen and Progesterone Receptors on Core Biopsy Specimens of Patients with Ductal Carcinoma in Situ (DCIS)

2018 ◽  
Vol 7 (2) ◽  
pp. 17
Author(s):  
Victoria Owens ◽  
Fang Liu ◽  
Amanda Lynn Heiter ◽  
Elizabeth Garber ◽  
James Wheeler
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Core Biopsy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Progesterone Receptors ◽  
Invasive Cancer ◽  
Invasive Component ◽  
Definitive Surgery

Purpose: To evaluate the value of estrogen and progesterone receptors on core biopsy specimens of patients with ductal carcinoma in situ. Introduction: The immunohistochemical determination of the estrogen receptor (ER) and progesterone receptor (PR) status is predictive of the response of patients with invasive cancer to hormonal therapy. The value of the receptor status prior to definitive surgery with either breast conservation or mastectomy for patients with ductal carcinoma in situ (DCIS) and no invasive component is less clear. Methods: We identified through the tumor registry 344 patients with breast cancer diagnosed from 2014 through 2015. Two hundred seventy-seven patients had invasive cancer at diagnosis. Results: Of the remaining 67 patients with DCIS or atypical hyperplasia alone on core biopsy, 15 (22%) patients were found to have invasive cancer at the time of definitive surgery. Forty-six patients without an invasive component had definitive surgery at the study institution, of which three had a component of higher grade DCIS than on the core biopsy. Fourteen patients (30%) underwent a mastectomy. Conclusion: A significant proportion (29%) of patients with DCIS alone on core biopsy had either an invasive component at the time of definitive surgery or a higher grade DCIS component. An additional 14/46 (30%) of patients chose mastectomy, for whom consideration of adjuvant endocrine therapy for contralateral risk reduction did not depend on the receptor status of the index DCIS. Cost savings could be realized if the determination of ER is deferred until after definitive surgery. Determination of PR on DCIS specimens can be omitted entirely.

scholarly journals Blurry Boundaries: Do Epithelial Borderline Lesions of the Breast and Ductal Carcinoma In Situ Have Similar Rates of Subsequent Invasive Cancer?

2012 ◽  
Vol 20 (4) ◽  
pp. 1302-1310 ◽  
Author(s):  
Daniel X. Choi ◽  
Anne A. Eaton ◽  
Cristina Olcese ◽  
Sujata Patil ◽  
Monica Morrow ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Invasive Cancer

Reflex Estrogen Receptor (ER) and Progesterone Receptor (PR) Analysis of Ductal Carcinoma In Situ (DCIS) in Breast Needle Core Biopsy Specimens

2016 ◽  
Vol 40 (8) ◽  
pp. 1090-1099 ◽  
Author(s):  
Christopher J. VandenBussche ◽  
Ashley Cimino-Mathews ◽  
Ben Ho Park ◽  
Leisha A. Emens ◽  
Theodore N. Tsangaris ◽  
...  
Keyword(s):  
Estrogen Receptor ◽  
Progesterone Receptor ◽  
Ductal Carcinoma In Situ ◽  
Core Biopsy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Needle Core Biopsy ◽  
Biopsy Specimens

Advocating Nonsurgical Management of Patients With Small, Incidental Radial Scars at the Time of Needle Core Biopsy: A Study of 77 Cases

2015 ◽  
Vol 139 (9) ◽  
pp. 1137-1142 ◽  
Author(s):  
Cathleen Matrai ◽  
Timothy M. D'Alfonso ◽  
Lindsay Pharmer ◽  
Michele B. Drotman ◽  
Rache M. Simmons ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Core Biopsy ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Radial Scar ◽  
Needle Core Biopsy ◽  
Ductal Hyperplasia

Context Radial scars are benign sclerosing lesions that are routinely excised when diagnosed in a needle core biopsy. Optimal management for patients with incidental and small (≤5 mm) radial scars is uncertain. Objective To assess pathologic upgrade of radial scars diagnosed in needle core biopsy samples and identify a subset of patients who could benefit from conservative management. Design Patients with a diagnosis of radial scar in a needle core biopsy who underwent excision of the biopsied area were identified. Radial scars greater than 5 mm in size and those with coexisting atypia, carcinoma, and papillary lesions were excluded. After histologic-radiographic correlation, rates of pathologic upgrade were assessed. Results Seventy-seven radial scars diagnosed in 66 patients were included. Overall, 9 of 77 (12%) showed upgrade to a high-risk lesion (6 lobular carcinoma in situ, 2 atypical ductal hyperplasia, 1 atypical lobular hyperplasia), while none (0%) showed upgrade to invasive carcinoma or ductal carcinoma in situ. One of 22 incidental radial scars (4.5%) showed upgrade on excision versus 6 of 36 (16.7%) for radial scars considered to be the radiographic target (P = .23). Older age was associated with upgrade (P < .001). Conclusions No incidental or small (≤5 mm) radial scars excised revealed invasive carcinoma or ductal carcinoma in situ on excision. Provided there is good pathologic-radiologic concordance, it appears reasonable for these patients to be managed conservatively.

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 Risk factors for the development of invasive cancer in unresected ductal carcinoma in situ

2018 ◽  
Vol 44 (4) ◽  
pp. 429-435 ◽  
Author(s):  
Anthony J. Maxwell ◽  
Karen Clements ◽  
Bridget Hilton ◽  
David J. Dodwell ◽  
Andrew Evans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Invasive Cancer

scholarly journals Study of Estrogen Receptor and Progesterone Receptor Expression in Breast Ductal Carcinoma In Situ by Immunohistochemical Staining in ER/PgR-Negative Invasive Breast Cancer

ISRN Oncology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Andrei Dobrescu ◽  
Monique Chang ◽  
Vatsala Kirtani ◽  
George K. Turi ◽  
Randa Hennawy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma In Situ ◽  
Invasive Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Receptor Expression ◽  
Invasive Cancer ◽  
Positive Staining ◽  
Receptor Status

Background. To our knowledge, the hormone receptor status of noncontiguous ductal carcinoma in situ (DCIS) occurring concurrently in ER/PgR-negative invasive cancer has not been studied. The current study was undertaken to investigate the ER/PgR receptor status of DCIS of the breast in patients with ER/PgR-negative invasive breast cancer. Methods. We reviewed the immunohistochemical (IHC) staining for ER and PgR of 187 consecutive cases of ER/PgR-negative invasive breast cancers, collected from 1995 to 2002. To meet the criteria for the study, we evaluated ER/PgR expression of DCIS cancer outside of the invasive breast cancer. Results. A total of 37 cases of DCIS meeting the above criteria were identified. Of these, 16 cases (43.2%) showed positive staining for ER, PgR, or both. Conclusions. In our study of ER/PgR-negative invasive breast cancer we found that in 8% of cases noncontiguous ER/PR-positive DCIS was present. In light of this finding, it may be important for pathologists to evaluate the ER/PgR status of DCIS occurring in the presence of ER/PgR-negative invasive cancer, as this subgroup could be considered for chemoprevention.

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