[In situ carcinomas of the breast: clinical features and therapeutic strategies].
BACKGROUND
Lobular and ductal carcinomas in situ of the breast (LCIS and DCIS) origin from the ductal-lobular unit of mammary gland, but they are characterized for different morphologic patterns and evolution. In 1980 they represent 1.4% of diagnosis in breast biopsy, less of 5% of carcinomas of the breast. Actually in 7.5% of breast biopsy an in situ carcinoma is recognized (approximating 40% of breast cancers). Our purpose is to evaluate the different available strategies in the clinic management of DCIS and LCIS and, in case of surgical treatment, which reconstructive approach obtains satisfactory breast conformation.


METHODS
The study enclose 125 patients: 40 of them presented LCIS (32%) and 85 DCIS (68%). In 40 patients (32%) underposed to mastectomy was performed a reconstruction in cooperation with aesthetic surgeons. 35 of 40 women with LCIS are included in a follow-up programme, 5 of them had a bilateral mastectomy and reconstruction.


RESULTS
No recurrences were observed in patients affected by LCIS. Six patients underposed to wide excision for DCIS developed local recurrence, treated by mastectomy. No recurrences were observed in patients treated initially with mastectomy. Some complications correlated to reconstruction were detected.


CONCLUSIONS
One of most controversial sights in breast pathology is the understanding of biological meaning of CLIS: in facts CDIS can be considered a pre-invasive cancer, CLIS is reasonably considerable only a risk indicator for developing breast cancer but it isn't a pre-neoplastic lesion. Very important is the reconstruction of the breast to improve the quality life of patients.
Attene
Federico
F
Università degli Studi di Sassari, Istituto di Patologia Chirurgica.
Scognamillo
Fabrizio
F
Trignano
Emilio
E
Meloni
Giovanni Battista
GB
Rubino
Corrado
C
Trignano
Mario
M
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011788:Quality of Life; D012307:Risk Factors