| Objective The Retrospective analysis of the clinical and pathological features of DCIS(ductal carcinoma in situ, DCIS) and infiltrating ductal carcinoma with micro (DCIS withmicroinvasion, DCIS-MI).Methods Patients who were included in the study were recruited between December2001to December2012from The General Hospital of Ningxia Medical University,101casesof DCIS and DCIS-MI patients were confirmed by pathology, including complete clinical dataand specimens preserved in paraffin.73cases of invasive ductal carcinoma (infiltrating ductalcarcinoma, IDC) patients were randomly selected from Electronic databases of breast cancer asControl group. The ER, PR, C-erbB-2, Ki-67expression were detccted byImmunohistochemistry (IHC) methods, Molecular typing were Grouped according to theconsensus of St.Gallen in2011, the Analysising the clinical and pathological features of DCISand DCIS-MI.Results1.In101cases of female breast carcinoma patients,37cases were DCIS,64cases wereDCIS-MI. the minimum age was25years old, the maximum age was71years old, the meanage was (49.28±9.890) years old.73cases of IDC as the control group. The lumps was the Thefirst symptom for DCIS, DCIS-MI and IDC,which accounting for78.3%,82.8%and95.9%;The nipple discharge, nipple erosion as the first symptoms were more common in DCIS andDCIS-MI.2.Small calcifications as the characteristics of DCIS and DCIS-MI. In our study, the Hypoechoic mass was the characteristics of DCIS, DCIS-MI and IDC in Breast ultrasound,which accounting for35.1%,60.9%and69.9%,the differences were statistically significant(P＜0.05); the Small calcifications as the characteristics of DCIS, DCIS-MI and IDC, whichaccounting for50%,51.6%and24.0%，the differences were statistically significant(P＜0.05).So, X-ray mammography was sensitive for the detection of small calcifications, Breastultrasound was sensitive for the detection of lumps. Therefore, it was clearly that X-raymammography take advantage for detecting of the DCIS and DCIS-MI.3.In DCIS group,20cases underwent modified radical mastectomy,2cases underwentbreast-conserving surgery,9cases underwent simple mastectomy,6cases underwentExpanding tumor resection，9cases underwent axillary lymph node dissection and no lymphnode metastasis were detected. In DCIS-MI group,56cases underwent modified radicalmastectomy，6cases underwent breast-conserving surgery,2cases underwent simplemastectomy, the Axillary lymph node metastasis were detected in15cases, the Axillarylymph node unmetastasis were detected in47cases. in IDC group,65cases underwentmodified radical mastectomy,8cases underwent breast-conserving surgery, the Axillarylymph node metastasis were detected in31cases, the Axillary lymph node unmetastasis weredetected in42cases. There were statistic difference between axillary lymph node metastasisin3groups (P<0.05).4.Histologic grade I was the most common type in DCIS group; histologic grade II wasthe most common type in DCIS-MI and IDC group, There were statistic difference betweenhistologic grade in3groups(P<0.05).5.In DCIS, DCIS-MI and IDC group,The ER positive expression rates were73.0%,60.9%and64.4%; The PR positive expression rates were64.9%,54.7%and61.6%; TheC-erbB-2positive expression rates were32.3%,40.0%and39.7%; The Ki-67<14%expression rates were32.4%,17.2%and12.3%. There were statistic difference betweenKi-67indexes in3groups(P<0.05). There were no statistic difference between ER, PR, C-erbB-2expression in3groups(P>0.05).6.The Luminal B molecular type was the most commom types in DCIS, DCIS-MI andIDC group，while there were no statistic difference between molecular type in3groups(P＞0.05)。Conclusion1.Mammography had the advantage in discovering slight calcification, which contributesto the diagnosis of DCIS.2.The histological grading of DCIS was really good and low expression of Ki-67hinted its better outcome.3.DCIS had no axillary lymphatic metastasis, which reminded that clinic can decide whether axillary lymph nodes excision was needed according to the condition sentinel node. |
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