title: The impact of field cancerization on the extent of duct carcinoma in situ (DCIS) in breast tissue after conservative excision.
abstract: OBJECTIVE
  Aim of the present study is to evaluate the risk of residual neoplastic foci, in patients treated with breast conservative surgery, based on duct carcinoma in situ (DCIS) grading.
  
  
  METHODS
  The study is based on a retrospective analysis of 419 resection specimens relative to 161 patients. All these patients underwent surgical re-excision when the first specimen had shown one or more margins involved by DCIS. Margins were oriented and the side of margin involved was recorded. Clonal analysis, using the mitochondrial DNA (mtDNA) technique, was obtained in selected cases.
  
  
  RESULTS
  Residual neoplastic foci were found in 145 out of 419 (34.6%) re-excised specimens. Specifically, residual foci of DCIS grade 2 and 3 were found more frequently in the margin facing the nipple (33.3% and 51.6%, respectively). On the contrary foci of DCIS grade 1 did not show any specific distribution. Clonal mt DNA analysis evidenced that DCIS grade 3 foci present in the re-excision specimens were genetically similar to the tumor removed in the first specimen, while DCIS grade 1 foci were not clonally related each other.
  
  
  CONCLUSIONS
  The present data further confirm that DCIS grade 3 is characterized by a circumscribed neoplastic process extending along the large ducts probably of a single mammary lobe. On the contrary DCIS grade 1 is characterized by multiple independent neoplastic foci, dispersed through several lobes indicating a field where multiple independent foci of cancer harbor.
authors.affiliation: Department of Biomedical and Neuromuscular Sciences, Anatomic Pathology Section "M. Malpighi", University of Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Asioli
authors.affiliation: Department of Biomedical and Neuromuscular Sciences, Anatomic Pathology Section "M. Malpighi", University of Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Morandi
authors.affiliation: Department of Biomedical and Neuromuscular Sciences, Anatomic Pathology Section "M. Malpighi", University of Bologna, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cavatorta
authors.affiliation: Unit of Oncologic Surgery, Bellaria Hospital, 40139 Bologna, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Cucchi
authors.affiliation: Department of Biomedical and Neuromuscular Sciences, Anatomic Pathology Section "M. Malpighi", University of Bologna, Italy. Electronic address: mariapia.foschini@unibo.it.
authors.forename: M P
authors.initials: MP
authors.lastname: Foschini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D004272:DNA, Mitochondrial / Q000235:genetics; D005260:Female; D006801:Humans; D000072662:Margins of Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D060787:Neoplasm Grading; D018365:Neoplasm, Residual; D009558:Nipples / Q000473:pathology; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA
chemical_list: D004272:DNA, Mitochondrial
keywords: Breast; Clonality; Field cancerization; In situ duct carcinoma; Invasive duct carcinoma; Resection margins