Analysis Of Clinical And Pathological Features And Prognosis Of Breast Intraductal Carcinoma With Microinvasion

Objective To analyze the clinicopathological features of intraductal carcinoma with micro-invasion,and to provide optimal treatment reference for such patients.Method Collected from January 2009 to December 2018 In yunnan province tumor hospital pathology diagnosed as intraductal Carcinoma With micro infiltration(Ductal Carcinoma In Situ With Microinvasion and DCIS-mi)of patients With relevant information,at the same time,on the basis of DCIS-mi.With age,stage,lymph node metastasis number as the matching condition,extraction of intraductal Carcinoma of the same period(Ductal Carcinoma In Situ,Invasive Ductal Carcinoma(IDC)was paired at a ratio of 1:2:3,and statistical analysis was conducted using SPSS23.0 software.With DCIS-mi and its associated DCIS and IDC cases,a comparative analysis would be made with the general situation,surgical treatment,pathological features,postoperative treatment and 3-year and 5-year OS(Overall survival),DFS(disease-free survival)and DDFS(Distant Disease free survival).Results In this study,a total of 54 cases of intraductal carcinoma with micro-invasion diagnosed and treated in the department of breast surgery of yunnan cancer hospital from 2009 to 2018 were collected,108 cases of intraductal carcinoma and 162 cases of invasive ductal carcinoma that met the matching requirements were enrolled,and a total of 324 cases in the three groups were collected.All cases were female.In this study,1(3.2%)of intraductal carcinoma with microinvasion was found to have positive axillary lymph node metastasis.The positive rate of axillary lymph nodes was the highest for invasive ductal carcinoma,followed by microinvasive ductal carcinoma,and the lowest for intraductal carcinoma(0%).The difference between the three groups was statistically significant(P<0.001).Histopathological grade:high grade intraductal carcinoma with microinvasion was more common(96.8%),high grade intraductal carcinoma was more common(51.9%),and low grade intraductal carcinoma was more common(77.7%).The proportion of intrductal carcinoma with microinvasive vascular thrombus was between intraductal carcinoma and invasive ductal carcinoma(9.3%),intraductal carcinoma was 0,and invasive ductal carcinoma was 14.8%,with statistically significant difference(P=0.026).The ER expression of intraductal carcinoma microinvasion was mostly negative(P=0.002)and her-2(2+)(50.0%),and the difference between the three groups was statistically significant(P<0.001).>14%(56.6%)was the predominant expression of ki-67 in intraductal carcinoma with microinvasion,and the difference between the three groups was statistically significant(P=0.001).Luminal b type(43.8%)and her-2 overexpression type(31.3%)were the main molecular types of intraductal carcinoma with microinvasion,and the differences among the three groups were statistically significant(P<0.0001).The follow-up time of intraductal carcinoma with micro-invasion was 0-72 months,and the median follow-up time was 16 months.There were 52 cases alive and 2 cases lost to follow-up.The 5-year overall survival rate,disease-free survival rate and distant metastatic survival rate showed no significant difference between intraductal carcinoma with micro-invasion and intraductal carcinoma,and the prognosis was better than that of invasive ductal carcinoma.Conclusion Through this research,it is concluded that micro intraductal carcinoma infiltration of axillary lymph node positive rate between intraductal carcinoma and infiltrating ductal carcinoma,and may be intraductal carcinoma development stages of transition to infiltrating ductal carcinoma,so can't underestimate lymph node status in clinical work,so the axillary lymph node needs to be done to assess,as the preferred way to sentinel lymph node biopsy,and then based on the status of lymph nodes decide whether to carry on the further treatment is needed.Luminal B type was dominant in the molecular typing of patients with intraductal carcinoma microinvasion.There was no significant difference in prognosis between intraductal carcinoma and intraductal carcinoma.