title: The clinical features and management of women with ductal carcinoma in situ with microinvasion: A retrospective Cohort study.
abstract: OBJECTIVE
  The purpose of our study is to demonstrate the clinical features and management of patients with Ductal Carcinoma in situ with microinvasion (DCISM) in a single Chinese cancer center.
  
  
  METHODS
  Retrospectively analysis of cases between 2003 and 2009 was performed in our institution. The type of treatments, pathological results, and axillary lymph nodes status, hormonal receptor statues (estrogen receptor (ER), progesterone receptor (PR) and Her2) were collected. The disease-free survival rate was calculated from the date of initial diagnosis using the Kaplan-Meier method.
  
  
  RESULTS
  Five hundred and sixty-seven cases were enrolled in our study, 474 pure Ductal Carcinoma in situ (DCIS) and 93 DCISM were included. Among these, 168 (35.4%) was diagnosed with the grade I and 26(5.5%) with grade III in pure DCIS group, compared with 3 (3.2%) and 11(11.8%) with grade I and III in DCISM (p < .0001). We also found that DCISM was associated with comadonecrosis histologic subtype (p < .0001) and presence of luminal B type (ER/PR positive and Her-2 positive) (p < .0032). There were more positive axillary lymph nodes involvement in patients with DCISM than those with DCIS after performing ALND(p = .0284). Patients with DCISM underwent more axillary lymph node dissection (ALND) in Chinese cancer center than those did in US centers (1.1% VS 47.8-68% and 86.1% VS 3.6-6.9%, respectively). No significantly difference was found in the overall survival rate between patients with DCIS and DCISM during median 100 months follow-up.
  
  
  CONCLUSIONS
  In a Chinese cancer hospital, the majority of cases underwent mastectomy and ALDN after the diagnosis of DCISM.The optimal treatments of patients with DCISM should be further investigated.
authors.affiliation: The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China. Electronic address: ddmm74@163.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China. Electronic address: weixi198204@126.com.
authors.forename: Xi
authors.initials: X
authors.lastname: Wei
authors.affiliation: The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China. Electronic address: ddmm74@163.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
keywords: Breast cancer; Chinese hospital; DCIS; DCISM; Management