Clinical Analysis Of 268 Cases Of Breast Ductal Carcinoma Insitu,ductal Carcinoma In Situ With Microinvasion And T1a-c Stage Breast Invasive Ductal Carcinoma

Objective: By comparing the clinical pathological characteristics and survival condition of ductal carcinoma in situ(DCIS),ductal carcinoma in situ with microinvasion(DCIS-MI)and stage T1a-c invasive ductal carcinoma(IDC T1a-c),to study the biological characteristics and prognosis of DCIS – MI,and to analyze the risk factors of invasion and microinvaison.Methods: retrospective analysis of the clinical and pathological data of 268 patients diagnosed as DCIS,DCIS-MI,IDC T1a-c in the first affiliated hospital of Chongqing medical university from the May 2011 to September 2016,and follow-up by telephone.Results: of the 268 cases,DCIS accounted for 101,DCIS-MI accounted for 65,IDC T1a-c accounted for 102.In 268 cases,84 patients with menarche age≤12y,and the proportion of DCIS,DCIS – MI and IDC T1a-c was 12.9% vs.17.2% vs.12.9% respectively(p < 0.001).A total of 207 cases with the first clinical symptom as mass,the proportion of 3 groups was 66.34%vs 80%vs86.27%.A total of 30 cases with the first clinical symptom as calcifications,of which DCIS accounted for 15 cases,DCIS-MI accounted for 7 cases,IDC T1a-c accounted for 8 cases,the difference was statistically significant(p < 0.01);in the group of IDC T1a-c,the proportion of core needle biopsy was 68.13%,which was higher than that of in the group of DCIS(37.62%)and the group of DCIS-MI(50.77%).In this study,there was no significant difference in the expression of hormone receptors among 3 groups.The proportion of the positive expression of HER-2 in the group of IDC T1a-c was significantly decreased(25.61%),compared with the group of DCIS(37.18%)and the group of DCIS-MI(47.62%).There were 118 cases with KI67≥14%,of which the proportion among 3 groups was 44.1%vs50.8%vs65.3% respectively.There were 33 cases with the metastasis of axillary lymph node,of which 2 belonged to the group of DCIS,2 belonged to the group of DCIS-MI,and 29 belonged to the group of IDC T1a-c.The postoperative median follow-up time was 34 months,only 1 patient died of breast cancer,and 5 patients had local recurrence or distant metastasis,and there was no significant difference in the survival rate among the 3 groups.The independent risk factors of invasion and microinvasion of DCIS was: the largest diameter of the lesion > 20 mm.Conclusion: The bigger of the lesion of DCIS,the more easily to have microinvaison and invasion.The clinical,pathological features and prognosis of DCIS-MI were between DCIS and IDC T1a-c.DCIS-MI was more aggressive than pure DCIS.