Is palpable DCIS more aggressive than screen-detected DCIS?
Background: Palpable ductal carcinoma in-situ (pDCIS) is a subset of DCIS presenting with a clinical mass. We hypothesized pDCIS would have more aggressive clinical and pathological features, and higher rates of recurrence and upgrade to invasive disease compared to screen-detected DCIS. Materials a...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Surgery Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589845022000793 |
| _version_ | 1828055122988498944 |
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| author | Nina Balac Robert M. Tungate Young Ju Jeong Heather MacDonald Lily Tung Naomi R. Schechter Linda Larsen Stephen F. Sener Julie E. Lang Kirstyn E. Brownson |
| author_facet | Nina Balac Robert M. Tungate Young Ju Jeong Heather MacDonald Lily Tung Naomi R. Schechter Linda Larsen Stephen F. Sener Julie E. Lang Kirstyn E. Brownson |
| author_sort | Nina Balac |
| collection | DOAJ |
| description | Background: Palpable ductal carcinoma in-situ (pDCIS) is a subset of DCIS presenting with a clinical mass. We hypothesized pDCIS would have more aggressive clinical and pathological features, and higher rates of recurrence and upgrade to invasive disease compared to screen-detected DCIS. Materials and methods: We performed a retrospective analysis of female patients (age 28–76) with DCIS on core-needle biopsy. pDCIS patients had a physician documented palpable mass prior to initial biopsy. Descriptive statistics were performed to compare groups. Results: This study included 83 patients, 26 had pDCIS and 57 had screen-detected DCIS. Mean duration of follow-up was 49.4 months. pDCIS patients had significantly larger lesions (p = 0.03) which were more frequently biopsied via ultrasound (p = 0.002). In multivariate analysis, pDCIS was associated with ultrasound guided core needle biopsy, size of DCIS >2 cm, and comedo pattern (p = 0.001, p = 0.007 and p = 0.022, respectively). 7.7 % of pDCIS cases versus 3.5 % of screen-detected cases were upgraded to invasive cancer (p = 0.59). There was no difference in local recurrence (p = 0.55) between groups. Neither group experienced regional or distant recurrence. Conclusions: pDCIS was associated with some aggressive pathologic and clinical features and was more frequently diagnosed by ultrasound guided core-needle biopsy than screen-detected DCIS. However, there was no significant difference in rate of recurrence or upgrade to invasive disease between groups. Key message: Although pDCIS was associated with some aggressive pathologic and clinical features, there was no significant difference in rate of recurrence or upgrade to invasive disease compared to screen-detected DCIS. |
| first_indexed | 2024-04-10T20:33:39Z |
| format | Article |
| id | doaj.art-221c0d2aa28741d89ff77872486e03dc |
| institution | Directory Open Access Journal |
| issn | 2589-8450 |
| language | English |
| last_indexed | 2024-04-10T20:33:39Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj.art-221c0d2aa28741d89ff77872486e03dc2023-01-25T04:16:11ZengElsevierSurgery Open Science2589-84502023-01-01118387Is palpable DCIS more aggressive than screen-detected DCIS?Nina Balac0Robert M. Tungate1Young Ju Jeong2Heather MacDonald3Lily Tung4Naomi R. Schechter5Linda Larsen6Stephen F. Sener7Julie E. Lang8Kirstyn E. Brownson9Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA; Corresponding author at: 1245 Park Avenue Apt 7A, New York, NY 10128, USA.Department of Internal Medicine, University of Southern California, Los Angeles, CA 90033, USADepartment of Surgery, Catholic University of Daegu School of Medicine, Daegu 42472, Republic of KoreaHoag Hospital, Irvine, CA 92618, USADepartment of Trauma Surgery and Critical Care, Vancouver General Hospital, Vancouver, British Columbia V5Z 1M9, CanadaDepartment of Radiation Oncology, University of Southern California, Los Angeles, CA 90033, USADepartment of Radiology, Division of Women's Imaging, University of Southern California, Los Angeles, CA 90033, USADivision of Breast, Endocrine, and Soft Tissue Surgery, Department of Surgery, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA; Department of Surgery, LAC+USC (LA County) Medical Center, Los Angeles, CA 90033, USADivision of Breast, Endocrine, and Soft Tissue Surgery, Department of Surgery, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA; Department of Surgery, LAC+USC (LA County) Medical Center, Los Angeles, CA 90033, USADivision of Breast, Endocrine, and Soft Tissue Surgery, Department of Surgery, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA; Department of Surgery, LAC+USC (LA County) Medical Center, Los Angeles, CA 90033, USABackground: Palpable ductal carcinoma in-situ (pDCIS) is a subset of DCIS presenting with a clinical mass. We hypothesized pDCIS would have more aggressive clinical and pathological features, and higher rates of recurrence and upgrade to invasive disease compared to screen-detected DCIS. Materials and methods: We performed a retrospective analysis of female patients (age 28–76) with DCIS on core-needle biopsy. pDCIS patients had a physician documented palpable mass prior to initial biopsy. Descriptive statistics were performed to compare groups. Results: This study included 83 patients, 26 had pDCIS and 57 had screen-detected DCIS. Mean duration of follow-up was 49.4 months. pDCIS patients had significantly larger lesions (p = 0.03) which were more frequently biopsied via ultrasound (p = 0.002). In multivariate analysis, pDCIS was associated with ultrasound guided core needle biopsy, size of DCIS >2 cm, and comedo pattern (p = 0.001, p = 0.007 and p = 0.022, respectively). 7.7 % of pDCIS cases versus 3.5 % of screen-detected cases were upgraded to invasive cancer (p = 0.59). There was no difference in local recurrence (p = 0.55) between groups. Neither group experienced regional or distant recurrence. Conclusions: pDCIS was associated with some aggressive pathologic and clinical features and was more frequently diagnosed by ultrasound guided core-needle biopsy than screen-detected DCIS. However, there was no significant difference in rate of recurrence or upgrade to invasive disease between groups. Key message: Although pDCIS was associated with some aggressive pathologic and clinical features, there was no significant difference in rate of recurrence or upgrade to invasive disease compared to screen-detected DCIS.http://www.sciencedirect.com/science/article/pii/S2589845022000793Sentinel lymph node biopsyBreast cancerRecurrence ratesDCISDuctal carcinoma in-situPalpable DCIS |
| spellingShingle | Nina Balac Robert M. Tungate Young Ju Jeong Heather MacDonald Lily Tung Naomi R. Schechter Linda Larsen Stephen F. Sener Julie E. Lang Kirstyn E. Brownson Is palpable DCIS more aggressive than screen-detected DCIS? Surgery Open Science Sentinel lymph node biopsy Breast cancer Recurrence rates DCIS Ductal carcinoma in-situ Palpable DCIS |
| title | Is palpable DCIS more aggressive than screen-detected DCIS? |
| title_full | Is palpable DCIS more aggressive than screen-detected DCIS? |
| title_fullStr | Is palpable DCIS more aggressive than screen-detected DCIS? |
| title_full_unstemmed | Is palpable DCIS more aggressive than screen-detected DCIS? |
| title_short | Is palpable DCIS more aggressive than screen-detected DCIS? |
| title_sort | is palpable dcis more aggressive than screen detected dcis |
| topic | Sentinel lymph node biopsy Breast cancer Recurrence rates DCIS Ductal carcinoma in-situ Palpable DCIS |
| url | http://www.sciencedirect.com/science/article/pii/S2589845022000793 |
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