Analysis On The Clinical Features Of Patients With Breast Ductal Carcinoma In Situ And Ductal Carcinoma In Situ With Microinvasion

Breast catheter carcinoma in situ, also known as ductal carcinoma in situ(DCIS), refers to the breast carcinoma in situ whose breast ductal epithelium had a monoclonal hyperplasia but without invading the basilar membrane and surrounding mesenchyme. Ductal carcinoma in situ with microinvasion(DCIS-MI)refers to the breast carcinoma in situ with the cancer cell breaking the basilar membrane and a infiltration lesion less than 0.1cm.With the popularization of breast ultrasonography, X-ray examination and minute lesion biopsy, the incidence of DCIS and DCIS-MI found by early detection was accordingly increased. It is generally acknowledged that, DCIS-MI is in a transitional stage before developing into invasive carcinoma; there are other researches showing that, the potential of DCIS-MI for invasion and metastasis may stand for an independent entity, which is different from DCIS. Objective:Explore the clinicpathologic features and prognostic of patients with DCIS and DCIS-MI. Method:This article is a retrospective clinical research conducted according to the BLOU database of the First Hospital of Jilin University, in which it screens out 51 cases of DCIS and 150 cases of DCIS-MI receiving surgical treatments and pathologically confirmed in the First Hospital of Jilin University from August 2005 to October 2014 and carries out analysis on the clinical pathological indexes such as the age of onset、tumor size、nuclear grading of Pathology、estrogen receptor(ER)、progesterone receptor(PR)、expression of Her-2 gene、selected surgical approach as well as postoperative adjuvant therapy etc, conducts statistical analysis by using SPSS18.0 statistical software, adopts x2 inspection and Fisher exact probabilityon differences between data, takes P<0.05 as the difference having statistical significance. Result:Both high incidence of ages for DCIS and DCIS-MI are averagely 45 years old~54 years old. In DCIS, there are 19 cases(37.3%) of tumors of sizes being<1cm, 17 cases(33.35) of tumors of sizes being 1-2 cm, 12 cases(23.5%) of sizes being 2-5 cm, 3 cases(5.9%) of sizes being >5cm; in DCIS-MI, there are 23 cases(15.3%)of tumors of sizes being <1cm, 45 cases(30.0%) of sizes being1-2cm, 76 cases(50.7%) of sizes being 2-5cm, 6 cases(4.0%) of sizes being>5cm. In DCIS, there are 42 cases(82.3%) of low-grade group, 3 cases(5.9%) of intermediate-grade group, 6 cases(11.8%) of high-grade group; in DCIS-MI, there are 124 cases(82.7%) in low-grade group, 3 cases(2.0%) of intermediate-grade group, 23 cases(15.3%) of high-grade group. In DCIS, 39 cases(76.5%) select full-breast resection, 12 cases(23.5%) select breast conserving surgery, in which there are 9 cases select breast conserving surgery with postoperative radiotherapy; in DCIS-MI, 130 cases(86.7%) select full-breast resection, 20 cases(13.3%) select breast conserving surgery, in which there are 17 cases select breast conserving surgery with postoperative radiotherapy. In DCIS, 24 cases(47.1%) select DCIS-MI sentinel node biopsy, 25 cases(49.0%) select axillary lymph node dissection, 2 cases(3.9%) don’t select axillary lymph node dissection; in DCIS-MI, 82 cases(54.7%) select sentinel node biopsy, 66 cases(44.0%) select axillary lymph node dissection, 2 cases(1.3%) don’t select axillary lymph node dissection. Positive rate of ER in DCIS is 80.4%, positive rate of PR is 76.5%; positive rate of ER in DCIS-MI is 56%, positive rate of PR is 50%. In DCIS, 36 cases(70.6%) receive endocrine therapy, the other 15 cases don’t receive endocrine therapy; In DCIS-MI, 30 cases(205) select chemotherapy, 54 cases(36%) select endocrine therapy, 25 cases(16.7%) select chemotherapy + endocrine therapy, 41 cases(27.3%) don’t receive adjuvant therapy. In the phone follow-up until October 2015, in DCIS, only 2 cases of death happened, however the death reason has nothing with breast cancer. In DCIS-MI, no case of dease happened, but contralateral breast cancer happened to 1 case, ipsilateral breast cancer happened to 1 case. Conclusion:1. High incidence age of DCIS and DCIS-MI are between 45 years old~55 years old. 2. Nuclear grading of pathology for DCIS and DCIS-MI are mostly in low grade. 3. Positive rate of ER、PR in DCIS are higher than those in DCIS-MI. 4. Both of DCIS and DCIS-MI can achieve a good prognosis.