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Blurry Boundaries: Do Epithelial Borderline Lesions of the Breast and Ductal Carcinoma In Situ Have Similar Rates of Subsequent Invasive Cancer?

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The histology of epithelial “borderline lesions” of the breast, which have features in between atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS), is well described, but the clinical behavior is not. This study reports subsequent ipsilateral breast events (IBE) in patients with borderline lesions compared with those with DCIS.

Methods

Patients undergoing breast-conserving surgery for borderline lesions or DCIS from 1997 to 2010 were identified from a prospective database. IBE was defined as the diagnosis of subsequent ipsilateral DCIS or invasive ductal carcinoma.

Results

A total of 143 borderline-lesion patients and 2,328 DCIS patients were identified. Median follow-up was 2.9 and 4.4 years, respectively. 7 borderline-lesion and 172 DCIS patients experienced an IBE. 5 year IBE rates were 7.7 % for borderline lesions and 7.2 % for DCIS (p = .80). 5 year invasive IBE rates were 6.5 and 2.8 %, respectively (p = .25). Similarly, when analyses were restricted to patients who did not receive radiotherapy, or endocrine therapy, or both, borderline-lesion and DCIS patients did not demonstrate statistically significant differences in rates of IBE or invasive IBE.

Conclusions

When compared with DCIS, borderline lesions do not demonstrate lower rates of IBE or invasive IBE. Despite “borderline” histology, a 5 year IBE rate of 7.7 % and an invasive IBE rate of 6.5 % suggest that the risk of future carcinoma is significant and similar to that of DCIS.

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Authors and Affiliations

  1. Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Daniel X. Choi MD, Cristina Olcese BS, Monica Morrow MD, FACS & Kimberly J. Van Zee MS, MD, FACS

  2. Biostatistics Service, Department of Biostatistics and Epidemiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Anne A. Eaton MS & Sujata Patil MPH, PhD

Authors
  1. Daniel X. Choi MD
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  2. Anne A. Eaton MS
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  3. Cristina Olcese BS
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  4. Sujata Patil MPH, PhD
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  5. Monica Morrow MD, FACS
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  6. Kimberly J. Van Zee MS, MD, FACS
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Correspondence to Kimberly J. Van Zee MS, MD, FACS.

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Choi, D.X., Eaton, A.A., Olcese, C. et al. Blurry Boundaries: Do Epithelial Borderline Lesions of the Breast and Ductal Carcinoma In Situ Have Similar Rates of Subsequent Invasive Cancer?. Ann Surg Oncol 20, 1302–1310 (2013). https://doi.org/10.1245/s10434-012-2719-2

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  • DOI: https://doi.org/10.1245/s10434-012-2719-2

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