Predictors of invasive breast cancer and lymph node involvement in ductal carcinoma in situ initially diagnosed by vacuum-assisted breast biopsy: experience of 733 cases.
OBJECTIVE
To predict presence of invasive component and nodal involvement in women diagnosed preoperatively with ductal carcinoma in situ (DCIS) by vacuum-assisted breast biopsy (VABB).


METHODS
We retrospectively analyzed 733 patients with preoperatively diagnosed DCIS, investigating the association of clinical-radiological variables with invasive component and nodal involvement.


RESULTS
Mammographic size >20 mm and residual lesion on post-VABB mammogram were related to invasive component (both p < 0.0001) and nodal involvement (p = 0.001, p = 0.03). Age <40 years was associated with presence of invasive component (p = 0.003). By multivariate analysis residual disease was associated with invasive component, and mammographic tumor size >20 mm with nodal involvement, both highly significant.


CONCLUSIONS
Older age, lesion <20 mm, and no residual lesion predict absence of invasion and no nodal involvement in VABB-diagnosed DCIS. However it would be imprudent to routinely forego sentinel node biopsy in such patients as non-negligible proportions of them have invasive disease.
Division of Breast Radiology, European Institute of Oncology, Via Ripamonti 435, Milan, Italy. chiara.trentin@ieo.it
Chiara
C
Trentin
Valeria
V
Dominelli
Patrick
P
Maisonneuve
Simona
S
Menna
Barbara
B
Bazolli
Alberto
A
Luini
Enrico
E
Cassano
D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008327:Mammography; D008408:Mastectomy; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D047368:Tumor Burden; D014618:Vacuum