Research On The Influencing Factors Of Pathological Underestimation Of Breast Ductal Carcinoma In Situ By Mammotome Biopsy

Breast cancer is one of the most common malignant tumor of women.Although more and more screening methods for early breast cancer were found,breast cancer is also a serious threat to women's quality and security of life with its increasing morbidity.The preoperative diagnosis for breast cancer is of great significance and relates to the choices of treatment.Mammotome is widely used in diagnosis and treatment of breast disease because of its accuracy in diagnosis,less damage and simple operation.Ductal carcinoma in situ(DCIS)is a malignant disease which occurs within the basement membrane and have a tendency to develop into invasive breast carcinoma.The clinical pathological diagnosis of DCIS is often underestimated.We retrospectively analyzed clinical data of 46 patients which were confirmed with DCIS in pathology by mammotome biopsy and accepted further surgery in the First Hospital of Jilin University during 2009 to 2015.We try to find the factors which influence the DCIS pathological underestimation in clinical practice to achieve higher accuracy.Objective:To investigate the influencing factors of pathological underestimation of DCIS by mammotome biopsy and provide theoretical foundation for individualized treatment.Methods:We retrospectively analyzed clinical data of 46 patients which confirmed with DCIS in pathology by mammotome biopsy in the First Hospital of Jilin University during 2009 to 2015.All the statistical data were analyzed by SPSS 22.0 software.Chi-square test or Fisher's exact text was performed to compare different factors of pathological underestimation of DCIS and multivariable Logistic regression analysis was performed to find the independent predictors of pathological underestimation of DCIS by mammotome biopsy.The statistical results with P< 0.05 were statistical significance.Results:All the 46 patients were female,mean age was 50.6.Postoperative pathology confirmed 31 cases of DCIS,10 cases of DCIS with microinvasion,4 cases of invasive ductal carcinoma,1 case of invasive cribriform carcinoma.Pathological underestimation was observed in 15 patients.The pathological underestimation of DCIS after mammotome biopsy was at a rate of 32.6%.After analyzing three factors of single factor with statistical significance by multivariable Logistic regression analysis,then calcification in mammography and biopsy sample number was confirmed as independent predictors of pathological underestimation of DCIS by mammotome biopsy.Relative risk OR values were 5.114 and 5.756.Pathological underestimation was likely to occur with the mass with calcification or the less biopsy sample number.Conclusion:The preoperative mammotome biopsy is accurate way to diagnose.We should pay much attention to the diagnosis of DCIS in preoperative biopsy when the mass with calcification in mammography.It should increase the number of biopsy sample to avoid pathological underestimation.