Histologic and Radiographic Analysis of Ductal Carcinoma In Situ Diagnosed Using Stereotactic Incisional Core Breast Biopsy

Background: Stereotactic incisional core breast biopsy (SCBB) is a highly specific technique for diagnosing ductal carcinoma in situ (DCIS) in patients with suspicious mammographic microcalcifications. However, its sensitivity for excluding the presence of coexisting occult invasive disease in this...

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Bibliographic Details
Published in:Modern pathology 2002-02, Vol.15 (2), p.95-101
Main Authors: Bonnett, Michelle, Wallis, Tracy, Rossmann, Michelle, Pernick, Nat L, Carolin, Kathryn A, Segel, Mark, Bouwman, David, Visscher, Daniel
Format: Article
Language:English
Subjects:
Biopsy
Biopsy - methods
Breast
Breast - pathology
Breast cancer
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - pathology
Carcinoma in Situ - diagnostic imaging
Carcinoma in Situ - pathology
Carcinoma, Ductal, Breast - diagnostic imaging
Carcinoma, Ductal, Breast - pathology
Ductal carcinoma in situ
Female
Humans
Laboratory Medicine
Lumpectomy
Mastectomy
Medicine
Medicine & Public Health
Middle Aged
original-article
Pathology
Radiography
Stereotactic core biopsy
Tumors
Ultrasonic imaging
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Summary:Background: Stereotactic incisional core breast biopsy (SCBB) is a highly specific technique for diagnosing ductal carcinoma in situ (DCIS) in patients with suspicious mammographic microcalcifications. However, its sensitivity for excluding the presence of coexisting occult invasive disease in this setting is not fully established. Design: We correlated SCBB findings to subsequent lumpectomy/mastectomy (lx/mx) results in 122 cases of DCIS. In 29 of these cases, the SCBB showed microscopic invasion (n = 15) or foci that were suspicious for invasion (n = 14). Likelihood for invasive disease in subsequent lx/mx samples from each case then was compared with various parameters, including DCIS grade, extent and mammographic findings. Results: Overall, 13% of cases in which the SCBB showed DCIS only (i.e., without any evidence of invasion), had invasive disease in the subsequent excision. This finding was significantly correlated with DCIS grade (low: 0/26 [0%], intermediate: 2/31 [6%], high: 10/36 [28%], P < .001). Invasive lesions were usually small (nine T1a, one T1b, and two T1c) and typically present within more extensive fields of DCIS (no invasion: 1.5 cm DCIS size; invasion: 2.8 cm mean DCIS size, P = .01). This was reflected by greater extent of involvement in the SCBB (5/8 cases with invasion had >15 ducts involved, versus 4/23 with
ISSN:0893-3952
1530-0285
DOI:10.1038/modpathol.3880497