Mammographic features of local recurrence in women who have undergone breast-conserving therapy for ductal carcinoma in situ
| Autor: | K J Van Zee, Laura Liberman, D. David Dershaw, Andrea F. Abramson, B Samli, Elizabeth A. Morris |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
Time Factors Mammary gland Breast Neoplasms Physical examination Mastectomy Segmental Sensitivity and Specificity Radiologic sign medicine Carcinoma Humans Mammography Radiology Nuclear Medicine and imaging skin and connective tissue diseases Retrospective Studies medicine.diagnostic_test business.industry Carcinoma Ductal Breast General Medicine Middle Aged Ductal carcinoma medicine.disease Surgery medicine.anatomical_structure Female Radiotherapy Adjuvant Neoplasm Recurrence Local business Carcinoma in Situ Follow-Up Studies |
| Zdroj: | American Journal of Roentgenology. 168:489-493 |
| ISSN: | 1546-3141 0361-803X |
| Popis: | This study was undertaken to evaluate the mammographic features of local recurrence in women who have undergone breast-conserving therapy for ductal carcinoma in situ (DCIS).Retrospective review revealed 162 women with DCIS treated with breast-conserving therapy from 1978 to 1990 for whom follow-up data were available. Subsequent to therapy, 33 (20%) patients had a pathologically proven carcinoma in the treated breast. Mammograms at the time of local recurrence were available for 20 patients. We reviewed mammograms, clinical charts, and histopathologic findings in these 20 patients. For 14 of 20 patients, we also reviewed mammograms obtained at the time of the original DCIS.The median interval from diagnosis of the original DCIS to local recurrence was 26 months (range, 6-168 months). Recurrences were detected solely by mammography in 17 (85%) of 20 patients, by mammography and physical examination in two (10%), and solely by physical examination in one (5%). Eighteen (90%) local recurrence contained calcifications and eighteen (90%) involved the tumorectomy quadrant. When we compared available mammographic findings of the original DCIS and the local recurrence we found the mammographic pattern and calcification morphology to be the same in 11 (79%) of 14 DCIS and nine (82%) of 11 DCIS, respectively. Histopathologic analysis of recurrences found DCIS in 13 (65%) of 20 patients and DCIS and infiltrating carcinoma in the remaining seven (35%) patients. Of 13 pure DCIS recurrences, 12 (92%) were detected solely by mammography.In our study, local recurrence after breast-conserving therapy for DCIS invariably contained DCIS; 35% of recurrences also contained invasive carcinoma. The most common mammographic pattern of local recurrence was calcifications in the tumorectomy quadrant that were morphologically similar to the original DCIS. These findings suggest that many of these local recurrences reflect failure to eradicate the primary DCIS. Mammography achieved high sensitivity in revealing these lesions: 85% of local recurrences and 92% of recurrences that were pure DCIS were detected solely by mammography. |
| Databáze: | OpenAIRE |
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