| Objective: Objective: To explore the clinical manifestations,diagnosis and prognosis of Ductal carcinoma in situ(DCIS)and Ductal carcinoma with microinfiltration(DCSI-MI).Methods: Clinical data of 121 patients pathologically diagnosed as DCIS were retrospectively analyzed,which were divided into Group A: DCIS group(96 cases)and Group B: DCIS-MI group(25 cases).The clinical manifestations,age,menstruation,family history,treatment,pathological characteristics and survival of patients in group A and B were compared.Results:(1)There was no difference between groups A and B in age,menstrual state,tumor blood supply,lesion calcification,lesion size,diagnostic method,surgical method,histological grade,ER and PR.The pathological accuracy of biopsy was statistically different between the two groups.(2)The main clinical manifestations of patients in group A and B were mass(79.3%),nipple discharge(12.4%)and calcification(24.8%).The upper quadrant outside the lesion site(47.9%)was dominant.(3)B-ultrasonography combined with mammography in imaging diagnosis can improve the diagnostic sensitivity.MRI supplementary examination of the suspicious lesions requires hollow needle biopsy for pathological diagnosis.Features of breast MRI images: high signal on T2WI(94.0%),high signal on DWI(100.0%),and low signal on ADC(92.0%).Patients in both groups were mainly treated by surgery,with ER positive adjuvant endocrine therapy and breast conserving adjuvant radiotherapy.The median follow-up of 60.5 months showed no difference in OS between group A and Group B(P=0.592).Conclusion:1.The clinical manifestations of DCIS and DCIS-MI are similar,most of which are thickened or small clustered local glands with unclear boundaries,diffuse calcification or masses,mainly masses;The lesions are mainly located in the outer upper quadrant.2.Clinical diagnosis of DCIS and DCIS-MI: B-ultrasonography combined with mammography is often used to improve the diagnostic sensitivity in imaging diagnosis of DCIS.For additional MRI examination of suspicious lesions,hollow needle biopsy is the standard for pathological diagnosis.The diagnosis of DCIS and DCIS-MI depends on the diagnosis of large multi-point biopsy specimens.3.Surgery was the main method for PATIENTS with DCIS and DCIS-MI,including breast-conserving surgery,mastectomy and sentinel lymph node biopsy,and there was no difference in 5-year overall survival rate.4.Adjuvant therapy for PATIENTS with DCIS and DCIS-MI: no chemotherapy is required,and breast protection requires radiotherapy;Endocrine therapy for ER positive patients,and targeted therapy is not recommended for HER-2 positive patients.There was no difference between DCIS and DCIS-MI. |
