Clinical Analysis Of37Cases Of Breast Ductal Carcinoma In Situ

Background and objective:The increased rate of early detection of breast cancer due to widespread mammography screening, ultrasound and magnetic resonance imaging has led to an increased detected rate of ductal carcinoma in situ (DCIS). In this article, we attempt to study the clinicopathological features, imaging data, immunohistochemical results and surgical treatment of DCIS in order to understand DCIS better, improve the rate of diagnosis.Patients and Methods:A retrospective study of37patients with DCIS is performed. Clinical statistics including age, menstrual condition, family history of malignant tumor, clinical features, tumor size, imaging data, needle core biopsy, immunohistochemical results and surgical treatments are analyzed. Results:The average diagnosed age was51.08and the median age was50years.40.5%incidence age of DCIS was from40to49. Most DCIS (81.1%) felt a palpable mass as their major clinical symptom, while nipple discharge could be found in24.3%DCIS patients. The diameter of two-thirds palpable mass is no more than2centimeters,26.7%had skin adhesion. Mammography showed70%DCIS had sand-like calcification. Ultrasound showed that80%had an irregular lump of low echo-level and31.4%had blood flow signals. Ultrasound and mammography examination had no significant difference in detecting of DCIS (P>0.05). The coincidence rate and diagnostic accuracy of needle core biopsy was54.2%, false-negative rate was12.5%. With post-operative histopathological diagnosis,28cases were DCIS,5cases were DCIS with microinvasion (DCIS-MI), and4cases were DCIS with Paget’s disease. The high nuclear grade was51.4%in DCIS. The positive expression of estrogen receptor (ER) in DCIS was61.8%, progesterone receptor (PR)58.8%and c-erbB-232.3%. High expression of Ki67(≥14%) was52.9%of DCIS while low expression (<14%) was47.1%.31cases out of37cases of DCIS had a mastectomy, and others received the breast conserving surgery. The result of20cases which had a sentinel lymph node biopsy (SLNB) and8cases which had direct axillary lymph node dissection (ALND) showed no lymph node metastases.Conclusion:High incidence age of DCIS was from40to49years old. The major clinical feature of DCIS is palpable mass and nipple discharge. Mammography and ultrasound examination can help diagnose DCIS. As SCNB has a certain false-negative rate, it need histopathological and histochemical test to diagnose DCIS after surgery. The surgical options for DCIS are either breast conserving surgery or mastectomy. ALND is not recommended to for pure DCIS, and SNLB should be considered and is beneficial to patients with DCIS.