Casting-type calcifications with invasion and high-grade ductal carcinoma in situ: a more aggressive disease?
| Autor: | Raul G. Zunzunegui, Jovita U. N. Oruwari, Daniel Golding, Maureen A. Chung, Blake Cady, Douglas J. Marchant |
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| Rok vydání: | 2003 |
| Předmět: |
Oncology
Adult medicine.medical_specialty Axillary lymph nodes medicine.medical_treatment Breast Neoplasms Breast cancer Internal medicine medicine Mammography Humans Neoplasm Invasiveness skin and connective tissue diseases Tumor marker medicine.diagnostic_test business.industry Carcinoma Ductal Breast Axillary Lymph Node Dissection Ductal carcinoma Sentinel node Middle Aged medicine.disease Prognosis Combined Modality Therapy Radiography medicine.anatomical_structure Carcinoma Intraductal Noninfiltrating Lymphatic Metastasis Surgery Female business Mastectomy |
| Zdroj: | Archives of surgery (Chicago, Ill. : 1960). 138(5) |
| ISSN: | 0004-0010 |
| Popis: | Hypothesis Women with breast cancer who have casting-type microcalcifications associated with multifocal invasion and extensive ductal carcinoma in situ (DCIS) form a subset of patients with a poor prognosis. Our study aims to identify the mammographic and pathologic features of this group. Design Women with casting-type microcalcifications, multifocal invasion, and extensive DCIS were identified from our tumor board registry. Mammographic features, tumor characteristics, treatment, and survival rates were evaluated. Invasive tumors were limited to 14 mm or smaller. Setting University medical teaching hospital and breast cancer specialty clinic. Results Of the 984 patients with breast cancer treated at our center, 15 patients were identified who had extensive casting-type calcifications and DCIS. Twelve of these patients also had multifocal invasive breast cancer. All had casting-type microcalcifications occupying more than 1 breast quadrant. All but 1 of the patients were treated using mastectomy with sentinel node biopsy or axillary node dissection. All but 1 patient had extensive grade 3 DCIS. Invasive tumors were negative for estrogen receptor and progesterone receptor expression in half of the patients, and 60% were positive for the HER-2-neu receptor. Positive axillary lymph nodes were found in 33% of patients, and 75% received adjuvant chemotherapy. After a median follow-up period of 20.5 months (range, 6-72 months), 1 patient had died and 1 had distant metastases. Of the 3 patients who had DCIS without invasion, 1 experienced a recurrence with infiltrating ductal carcinoma. Conclusions In women with small multifocal breast cancers with extensive casting calcifications and DCIS, the incidence of positive lymph nodes was 33%, with a tendency for poor tumor markers. These women appear to be at substantial risk for systemic disease; lymph node sampling and adjuvant systemic therapy are recommended. |
| Databáze: | OpenAIRE |
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