Predictive factors for the presence of invasive components in patients diagnosed with ductal carcinoma in situ based on preoperative biopsy

• Published in: BMC cancer 2019-12, Vol.19 (1), p.1201-1201, Article 1201
• Main Authors: Lee, Kwan Ho, Han, Jeong Woo, Kim, Eun Young, Yun, Ji Sup, Park, Yong Lai, Park, Chan Heun
• Format: Article
• Language: English
• Subjects: Adult; Age; Biological markers; Biomarkers; Biopsy; Biopsy, Needle; Breast; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breast surgery; Cancer; Carcinoma; Carcinoma, Intraductal, Noninfiltrating - diagnostic imaging; Carcinoma, Intraductal, Noninfiltrating - pathology; Carcinoma, Intraductal, Noninfiltrating - surgery; Chemotherapy; Diagnosis; Diagnostic imaging; Ductal carcinoma in situ; Female; Gadobutrol; Health aspects; Humans; Invasiveness; Lymphatic system; Magnetic Resonance Imaging; Mammography; Mastectomy; Medical research; Middle Aged; Multivariate analysis; Neoplasm Invasiveness; NMR; Nuclear magnetic resonance; Pathology; Patients; Radiation therapy; Retrospective Studies; Risk Factors; Statistical analysis; Studies; Surgery
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-019-6417-3

In patients diagnosed with ductal carcinoma in situ (DCIS) with needle biopsy before surgery, invasive component (IC) is often found in the postoperative tissue, which results in altered post-surgical care. However, there are no clinically available factors to predict IC, and few MRI studies are available for the detection of IC in DCIS patients. The purpose of this study was to evaluate which risk factors can predict IC preoperatively. Patients with a DCIS diagnosis based on preoperative biopsy, who underwent breast surgery Kangbuk Samsung Hospital between Jan 2005 and June 2018, were retrospectively evaluated. Clinico-pathological and breast MRI factors were compared between DCIS and DCIS with IC in postsurgical specimens. Of the 431 patients with a preoperative diagnosis of DCIS, 34 (7.9%) showed IC during the postoperative pathological investigations, and 217 (50.3%) underwent breast MRI. Among MRI-related factors, Mass-like enhancement on MRI was the sole but significant predictor of IC (HR = 0.26, C.I. = 0.07-0.93, p = 0.038), while nipple-areolar complex invasion, enhancement peak and pattern were not statistically significant. Nuclear grade was the only significant predictor of IC in the analysis of other clinico-pathological factors (HR = 2.39, C.I. = 1.05-5.42, p = 0.038 in univariate analysis, HR = 2.86, C.I. = 1.14-7.14, p = 0.025 in multivariate analysis). Mass-like enhancement on MRI and high nuclear grade were associated with IC in patients with preoperative diagnosis of DCIS. Considering the high sensitivity of breast MRI for IC, further evaluation of the predictive value of MRI in preoperative DCIS patients is desirable.