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Carcinoma in situ of the female breast. 10 year follow-up results of a prospective nationwide study

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Abstract

In a Danish nationwide prospective study of in situ carcinoma of the breast, a total of 275 women, treated with excision alone, were registered from 1982 to 1989. The series included 142 cases of ductal carcinoma in situ (DCIS), 100 cases of lobular carcinoma situ (LCIS), 26 cases of DCIS+LCIS, and seven cases of atypical hyperplasia (AH). Within a median follow-up of 120 months, a crude recurrence rate of 28% (76 cases) was found, of which 53% (40 cases) recurred as invasive carcinomas (IC) and 47% (36 cases) as CIS. CIS recurrences appeared after median 18 months, compared to median 42 months for IC recurrences. No statistical difference was found with respect to development of IC between the three groups of DCIS, DCIS+LCIS, and LCIS. The majority of recurrences were ipsilateral, also for LCIS. Forty four of 49 recurrences following DCIS, and seven of nine recurrences following DCIS+LCIS occurred as local recurrences. Histopathologically, in DCIS a strong association was found between large nuclear size and comedonecrosis. Univariate analysis showed a significant association to recurrence for nuclear size, comedonecrosis, and size of the original lesion. Multivariate analysis showed that only comedonecrosis and size of lesion were independent predictors of recurrence, however, specimen margins were not included in the analysis, as this parameter could not be adequately evaluated in the present series. Nuclear size of original DCIS lesion was related to histologic grade of the IC recurrence. The recurrence rate for DCIS of small nuclear size increased from 6% at five years of follow-up to 16% at 10 years, possibly due to a slower growth rate and a continued but delayed risk. Similarities were found between LCIS and DCIS of small nuclear size, both showing a continued risk and comparable rate of recurrence. Further, progression of IC to similar, highly differentiated type was seen, indicating a linkage between biological behavior of the two histological types.

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References

  1. Ottesen GL, Graversen HP, Blichert-Toft M, Zedeler K, Andersen JA: Ductal carcinoma in situ of the female breast. Short-term results of a prospective nationwide study. The Danish Breast Cancer Cooperative Group. Am J Surg Pathol 16: 1183–1196, 1992

    Google Scholar 

  2. Ottesen GL, Graversen HP, Blichert-Toft M, Zedeler K, Andersen JA: Lobular carcinoma in situ of the female breast. Shrot-term results of a prospective nationwide study. The Danish Breast Cancer Cooperative Group. Am J Surg Pathol 17: 14–21, 1993

    Google Scholar 

  3. WHO: Histological Typing of Breast Tumours. 2nd eds Geneva, 1981

  4. Azzopardi JG: Problems in Breast Pathology. London: WB Saunders Vol. 11, pp. 113–66, pp. 192-233, 1979

    Google Scholar 

  5. Andersen JA, Nielsen M, Blichert-Toft M. The growth pattern of in situ carcinoma in the female breast. Acta Oncol 27: 739–743, 1988

    Google Scholar 

  6. Ottesen GL, Christensen IJ, Larsen JK, Larsen J, Baldetorp B, Linden T, Hansen B, Andersen JA: Carcinoma in situ of the breast: Correlation of histopathology to immunohistochemical markers and DNA ploidy. Breast Cancer Res Treat, 60: 219–226, 2000

    Google Scholar 

  7. Rosai J: Borderline epithelial lesions of the breast. Am J Surg Pathol 15: 209–221, 1991

    Google Scholar 

  8. Consensus conference on the classification of ductal carcinoma in situ. Cancer 80: 1798–1802, 1997

    Google Scholar 

  9. Silverstein MJ, Barth A, Poller DN, Gierson ED, Colburn WJ, Waisman JR, Gamagami P: Ten-year result comparing mastectomy to excision and radiation therapy for ductal carcinoma in situ of the breast. Eur J Cancer 31A: 1425–1427, 1995

    Google Scholar 

  10. Sneige N, McNeese MD, Atkinson EN, Ames FC, Kemp B, Sahin A, Ayala AG: Ductal carcinoma in situ treated with lumpectomy and irradiation: histopathological analysis of 49 specimens with emphasis on risk factors and long term results. Hum Pathol 26: 642–649, 1995

    Google Scholar 

  11. Fisher ER, Costantino J, Fisher B, Palekar AS, Redmond C, Mamounas E: Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) Protocol B-17. Intraductal carcinoma (ductal carcinoma in situ). Cancer 75: 1310–1319, 1995

    Google Scholar 

  12. Silverstein MJ, Poller DN, Waisman JR, Colburn WJ, Barth A, Gierson ED, Lewinsky B, Gamagami P, Slamon DJ: Prognostic classification of breast ductal carcinoma-in situ. Lancet 345: 1154–1157, 1995

    Google Scholar 

  13. Bellamy CO, McDonald C, Salter DM, Chetty U, Anderson TJ: Noninvasive ductal carcinoma of the breast: the relevance of histologic categorization. Hum Pathol 24: 16–23, 1993

    Google Scholar 

  14. Schwartz GF, Finkel GC, Garcia JC, Patchefsky AS: Subclinical ductal carcinoma in situ of the breast. Treatment by local excision and surveillance alone. Cancer 70: 2468–2474, 1992

    Google Scholar 

  15. Lagios MD, Margolin FR, Westdahl PR, Rose MR: Mammographically detected duct carcinoma in situ. Frequency of local recurrence following tylectomy and prognostic effect of nuclear grade on local recurrence. Cancer 63: 618–624, 1989

    Google Scholar 

  16. Lagios MD: Ductal carcinoma in situ: Controversies in diagnosis, biology, and treatment. Breast J 1: 68–78, 1995

    Google Scholar 

  17. Rosen PP, Braun DW, Kinne DE: The clinical significance of pre-invasive breast carcinoma. Cancer 46(4): 919–925, 1980

    Google Scholar 

  18. Page DL, Dupont WD, Rogers LW, Jensen RA, Schuyler PA: Continued local recurrence of carcinoma 15-25 years after a diagnosis of low grade ductal carcinoma in situ of the breast treated only by biopsy. Cancer 76: 1197–2000, 1995

    Google Scholar 

  19. Morrow M: The natural history of ductal carcinoma in situ. Implications for clinical decision making [editorial] Cancer 76: 1113–1115, 1995

    Google Scholar 

  20. Holland R, Hendriks JH, Verbeek AL, Mravunac M, Schurmans Stekhoven JH: Extent, distribution, and mammographic/ histologic correlations of breast ductal carcinoma in situ. Lancet 335: 519–522, 1990

    Google Scholar 

  21. Holland R, Hendriks JH: Microcalcifications associated with ductal carcinoma in situ: Mammographic-pathologic correlation. Semin Diagn Pathol 11: 181–192, 1994

    Google Scholar 

  22. Faverly DR, Burgers L, Bult P, Holland R: Three dimensional imaging of mammary ductal carcinoma in situ: Clinical implications. Semin Diagn Pathol 11: 193–198, 1994

    Google Scholar 

  23. Silverstein MJ, Lagios MD, Craig PH, Waisman JR, Lewinsky BS, Colburn WJ, Poller DN: A prognostic index for ductal carcinoma in situ of the breast. Cancer 77: 2267–2274, 1996

    Google Scholar 

  24. Andersen JA: Lobular carcinoma in situ. A histological study of 52 cases. Acta Path Microbiol Scand 82: 735–741, 1974

    Google Scholar 

  25. Haagensen CD, Lane N, Lattes R, Bodian C: Lobular neoplasia (so-called lobular carcinoma in situ) of the breast. Cancer 42: 737–769, 1978

    Google Scholar 

  26. Bodian CA, Perzin KH, Lattes R: Lobular neoplasia. Long term risk of breast cancer and relation to other factors. Cancer 78: 1024–1034, 1996

    Google Scholar 

  27. Page DL, Kidd TE, Dupont WD, Simpson JF, Rogers LW: Lobular neoplasia of the breast: higher risk for subsequent invasive cancer predicted by more extensive disease. Hum Pathol 22: 1232–1239, 1991

    Google Scholar 

  28. Rosen PP, Lieberman PH, Braun DW, Kosloff C, Adair F: Lobular carcinoma in situ of the breast. Detailed analysis of 99 patients with average follow-up of 24 years. Am J Surg Pathol 2: 225–251, 1978

    Google Scholar 

  29. Wheeler JE, Enterline HT, Roseman JM, Tomasulo JP, McIlvaine CH, Fitts WT, Kirshenbaum J: Lobular carcinoma in situ of the breast. Long-term followup. Cancer 34: 554–563, 1974

    Google Scholar 

  30. Fisher ER, Costantino J, Fisher B, Palekar AS, Paik SM, Suarez CM, Wolmark N: Pathologic findings from the National Surgical Adjuvant Breast (NSABP) Protocol B-17. Five-year observations concerning lobular carcinoma in situ. Cancer 78: 1403–1413, 1996

    Google Scholar 

  31. Lakhani SR, Collins N, Sloane JP, Stratton MR: Loss of heterozygosity in lobular carcinoma in situ of the breast. J Clin Pathol: Mol Pathol 48: M74–M78, 1995

    Google Scholar 

  32. Stratton MR, Collins N, Lakhani SR, Sloane JP: Loss of heterozygosity in ductal carcinoma in situ of the breast. J Pathol 175: 195–201, 1995

    Google Scholar 

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Authors
  1. Gyda Lolk Ottesen
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  2. Hans Peder Graversen
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  3. Mogens Blichert-Toft
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  4. Ib Jarle Christensen
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  5. Johan A. Andersen
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Ottesen, G.L., Graversen, H.P., Blichert-Toft, M. et al. Carcinoma in situ of the female breast. 10 year follow-up results of a prospective nationwide study. Breast Cancer Res Treat 62, 197–210 (2000). https://doi.org/10.1023/A:1006453915590

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