Abstract
Objective: To study the implications of Ductal Carcinoma In Situ (DCIS) diagnosis in Core Needle Biopsies (CNBs) of the breast. Method: The histology slides of 59 CNBs and BCS (Breast conserving surgery) /Mastectomy were reviewed for the presence and percentage of DCIS and 63 BCS were reviewed for positivity of the surgical margins. SPSS -13 and appropriate statistical tests were used for analysis. Results: The sensitivity of CNB to predict DCIS in the surgical specimen was 45.65%. A positive relationship was established between DCIS positivity in CNB and DCIS percentage in the subsequent surgical specimen (p=0.002). A positive correlation exists between the number of positive margins and percentage of DCIS (p Conclusion: DCIS in CNB is often associated with DCIS in BCS/mastectomy in a higher percentage of the same. A higher percentage of DCIS frequently has positive BCS margins, thus wider excisions are indicated for women with DCIS positive CNB's. Sensitivity of identifying DCIS in the CNB increases with number of CNB cores. DOI: http://dx.doi.org/10.4038/jdp.v6i1.4419 Journal of Diagnostic Pathology 2011(6); 1: 28-33
Highlights
The presence of Ductal carcinoma in situ (DCIS) increases the risk of subsequent invasive carcinoma of the breast
Extensive intraduct component (EIC) refers to invasive carcinoma where DCIS represents 25% or more of the tumour and extending beyond the main tumour mass (4)
Sensitivity of Core Needle Biopsies (CNBs) to predict the presence of DCIS in the definitive surgical specimen
Summary
The presence of Ductal carcinoma in situ (DCIS) increases the risk of subsequent invasive carcinoma of the breast. Core needle biopsy (CNB) is widely used to obtain tissue for histological evaluation from mammographically detected, non palpable and palpable breast lesions (2,3). Following a CNB diagnosis of either in situ or invasive duct carcinoma, the type of surgery planned is influenced by therapeutic as well as cosmetic factors. The presence of EIC in the breast conserving surgical specimens (BCS) increases the risk for recurrence (5). Its usefulness in Implications of diagnosing ductal carcinoma in situ in core needle biopsies of the breast predicting positive margins is limited (4). The absence of DCIS in CNB is documented to exclude the possibility of eventually identifying EIC in the subsequent surgical specimen (4). Carcinoma of the breast is the commonest malignancy among women worldwide, including Sri Lankan women (6,7)
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