title: Impact of the presence and quantity of ductal carcinoma in situ component on the outcome of invasive breast cancer.
abstract: BACKGROUND
  The role of ductal carcinoma in situ (DCIS) component on the outcome of invasive breast cancer is not yet completely clear. Our study aims to assess the impact of the presence and quantity of DCIS component on the outcome of patients operated for invasive breast cancer.
  
  
  METHODS
  We collected retrospective data about patients operated at their breast for invasive cancer between 2007 and 2012, focusing on the presence of DCIS component. Then, we divided patients into four groups based on the quantity of DCIS component as follows: not found (group A), minimal (group B, <25%), extensive (group C, 25-75%), and prevalent (group D, >75%). We further defined "extensive intraductal component" (EIC) groups C and D together.
  
  
  RESULTS
  DCIS component was associated with young age, familial history of breast cancer and worse biological characteristics, including high grading, higher prevalence of Her2/Neu overexpression, hormone receptors negativity, comedo-like necrosis and multifocality/multicentricity. Despite the unfavorable prognostic factors, invasive cancers associated with EIC were frequently treated with radical surgery and resulted to have long disease-free survival and low local recurrence rate. In patients with DCIS component (groups B, C, and D) the extension of this component resulted indirectly correlated with local recurrence rate, tumor lymphovascular invasion, and lymphnode extracapsular invasion. The highest prevalence of local recurrences was found in group B, which tended to be less frequently treated with radical surgery than group D (P<0.05) and C (P=n.s.).
  
  
  CONCLUSIONS
  Different clinical and tumor features among invasive breast cancer with and without DCIS component indicate that they are distinct entities probably originating by different pathways that deserve to be studied. Furthermore, the controversial results about the management of cancer with minimal intraductal component require further studies in order to reduce local recurrence.
authors.affiliation: Clinic of Surgery, AOU "Santa Maria della Misericordia", DISM, DSMB, University of Udine, Piazzale Santa Maria della Misericordia Udine 15-33100, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Cedolini
authors.affiliation: Clinic of Surgery, AOU "Santa Maria della Misericordia", DISM, DSMB, University of Udine, Piazzale Santa Maria della Misericordia Udine 15-33100, Italy ; Department of Surgical Oncology, IRCSS CRO Via Franco Gallini, Aviano (PN) 2-33081, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Bertozzi
authors.affiliation: Unit of Obstetrics and Gynecology, S Polo Hospital via Galvani, Monfalcone (GO) 1-34074, Italy.
authors.forename: Ambrogio P
authors.initials: AP
authors.lastname: Londero
authors.affiliation: Clinic of Surgery, AOU "Santa Maria della Misericordia", DISM, DSMB, University of Udine, Piazzale Santa Maria della Misericordia Udine 15-33100, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Seriau
authors.affiliation: Clinic of Surgery, AOU "Santa Maria della Misericordia", DISM, DSMB, University of Udine, Piazzale Santa Maria della Misericordia Udine 15-33100, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Andretta
authors.affiliation: Clinic of Surgery, AOU "Santa Maria della Misericordia", DISM, DSMB, University of Udine, Piazzale Santa Maria della Misericordia Udine 15-33100, Italy.
authors.forename: Diane
authors.initials: D
authors.lastname: Agakiza
authors.affiliation: Radiotherapy Unit, AOU "Santa Maria della Misericordia" Udine 33100, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Fongione
authors.affiliation: Clinic of Surgery, AOU "Santa Maria della Misericordia", DISM, DSMB, University of Udine, Piazzale Santa Maria della Misericordia Udine 15-33100, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Uzzau
authors.affiliation: Clinic of Surgery, AOU "Santa Maria della Misericordia", DISM, DSMB, University of Udine, Piazzale Santa Maria della Misericordia Udine 15-33100, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Risaliti
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies
keywords: Breast cancer; disease-free survival; ductal carcinoma in situ component; extensive intraductal component; overall survival