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Nonpalpable In Situ Ductal Carcinoma of the Breast: Predictors of Multicentricity and Microinvasion and Implications for Treatment

Nonpalpable In Situ Ductal Carcinoma of the Breast: Predictors of Multicentricity and... Abstract • Fifty breasts with nonpalpable ductal carcinoma in situ (DCIS) were examined for the presence of microinvasion, multicentricity, and number of involved ducts to see if the biopsy specimen could have predicted the findings in the remainder of the breast. When DCIS was an incidental finding, fewer ducts were involved and no evidence of either microinvasion or multicentricity was found. Solid and cribriform DCIS were rarely multicentric or microinvasive; micropapillary DCIS was often multicentric, rarely microinvasive; comedocarcinoma was more likely to be both microinvasive and multicentric. Ductal carcinoma in situ as an incidental finding may be treated by excision alone; papillary and micropapillary DCIS are best treated by therapy aimed at the entire breast, although axillary dissection may not be required. Therapy for comedocarcinomas should include the entire breast and the axillary nodes. (Arch Surg 1989;124:29-32) References 1. Schwartz GF, Feig SA, Patchefsky AS: Significance and staging of nonpalpable carcinomas of the breast . Surg Gynecol Obstet 1988;166:6-10. 2. Schwartz GF, Patchefsky AS, Feig SA, et al: Clinically occult breast cancer: Multicentricity and implications for treatment . Ann Surg 1980; 191:8-12.Crossref 3. Pathology Working Group, Breast Cancer Task Force: Standardized management of breast cancer specimens . Am J Clin Pathol 1973;60:789-798. 4. Betsill WL, Rosen PP, Lieberman PH, et al: Intraductal carcinoma: Long term follow-up after treatment by biopsy alone . Cancer 1978;239: 1863-1867. 5. Page DL, Dupont WD, Rogers OW, et al: Intraductal carcinoma of the breast: Followup after biopsy only . Cancer 1982;49:751-758.Crossref 6. Gump FE, Jicha DL, Ozello L: Ductal carcinoma in situ (DCIS): A revised concept . Surgery 1987;102:790-795. 7. Silverstein MJ, Rosser RJ, Gierson ED, et al: Axillary lymph node dissection for intraductal breast carcinoma: Is it indicated? Cancer 1987; 59:1819-1824.Crossref 8. Schnitt SJ, Silen W, Sadowsky NL, et al: Ductal carcinoma in situ (intraductal carcinoma) of the breast . N Engl J Med 1988;318:898-903.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Nonpalpable In Situ Ductal Carcinoma of the Breast: Predictors of Multicentricity and Microinvasion and Implications for Treatment

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Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1989.01410010035007
Publisher site
See Article on Publisher Site

Abstract

Abstract • Fifty breasts with nonpalpable ductal carcinoma in situ (DCIS) were examined for the presence of microinvasion, multicentricity, and number of involved ducts to see if the biopsy specimen could have predicted the findings in the remainder of the breast. When DCIS was an incidental finding, fewer ducts were involved and no evidence of either microinvasion or multicentricity was found. Solid and cribriform DCIS were rarely multicentric or microinvasive; micropapillary DCIS was often multicentric, rarely microinvasive; comedocarcinoma was more likely to be both microinvasive and multicentric. Ductal carcinoma in situ as an incidental finding may be treated by excision alone; papillary and micropapillary DCIS are best treated by therapy aimed at the entire breast, although axillary dissection may not be required. Therapy for comedocarcinomas should include the entire breast and the axillary nodes. (Arch Surg 1989;124:29-32) References 1. Schwartz GF, Feig SA, Patchefsky AS: Significance and staging of nonpalpable carcinomas of the breast . Surg Gynecol Obstet 1988;166:6-10. 2. Schwartz GF, Patchefsky AS, Feig SA, et al: Clinically occult breast cancer: Multicentricity and implications for treatment . Ann Surg 1980; 191:8-12.Crossref 3. Pathology Working Group, Breast Cancer Task Force: Standardized management of breast cancer specimens . Am J Clin Pathol 1973;60:789-798. 4. Betsill WL, Rosen PP, Lieberman PH, et al: Intraductal carcinoma: Long term follow-up after treatment by biopsy alone . Cancer 1978;239: 1863-1867. 5. Page DL, Dupont WD, Rogers OW, et al: Intraductal carcinoma of the breast: Followup after biopsy only . Cancer 1982;49:751-758.Crossref 6. Gump FE, Jicha DL, Ozello L: Ductal carcinoma in situ (DCIS): A revised concept . Surgery 1987;102:790-795. 7. Silverstein MJ, Rosser RJ, Gierson ED, et al: Axillary lymph node dissection for intraductal breast carcinoma: Is it indicated? Cancer 1987; 59:1819-1824.Crossref 8. Schnitt SJ, Silen W, Sadowsky NL, et al: Ductal carcinoma in situ (intraductal carcinoma) of the breast . N Engl J Med 1988;318:898-903.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1989

References

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