Effect of the Ductal Carcinoma In Situ Margin Consensus Guideline Implementation on Re-Excision Rates, Satisfaction, and Cost

Bhutiani, Neal; Holland, Michelle; Mercer, Megan; Donaldson, Marilyn; Berry, Tiffany S.; McMasters, Kelly M.; Ajkay, Nicolás

doi:10.1245/s10434-021-10120-z

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“…According to local recurrence, the unique randomized clinical trial specifically restricted to DCIS, published by McCormick et al, showed that unicentric disease, tumor size ≤2.5 cm, grade 1 or 2 and negative margins greater than 3 mm are factors of low risk of recurrence in patients treated with breast conserving surgery 32 . The current consensus guidelines for margins in DCIS recommend 2 mm to decrease local recurrence rates 33 , and some studies include comedonecrosis as a pathological feature of high risk of recurrence 34 . In our study, none of the characteristics (mean size of 12 mm [IQR 18.9]), 55% of high-grade tumors, 55.7% of comedo DCIS, and 63.2% of luminal tumors) were correlated to local failure.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and recurrence risk in patients with ductal carcinoma in situ of the breast

et al. 2023

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Introduction: With the widespread adoption of mammographic screening for breast cancer, ductal carcinoma in situ (DCIS) has been detected more frequently. In developing countries, the prevalence of ductal carcinoma in situ is low due to the opportunistic nature of breast cancer screening. The aim of this study was to evaluate the clinicopathological characteristics and recurrence rate in a cohort of patients with ductal carcinoma in situ in Brazil. Methods: This study was an retrospective analysis of all 1,736 patients with non-metastatic breast cancer treated at a reference public hospital between 1999 and 2013. All data were collected from medical records and the descriptive statistics were performed to characterize the clinical and pathological features. Results: In the present cohort, we identified 102 (5.2%) patients with non-invasive breast neoplasms. Mean age at diagnosis was 54±12.7 years and most patients were treated with breast conserving surgery. There is a strong association between nuclear grade and the expression of estrogen and progesterone receptors in ductal carcinoma in situ. Ipsilateral and contralateral recurrence rates in 10 years were 7.2% and 2%, respectively. Conclusion: The pathological features of ductal carcinoma in situ diagnosed in Brazil are similar to those observed in patients diagnosed in countries following a systematic screening program, and the treatment in our patients achieves similar success compared with published data in high-income countries.

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Section: Discussionmentioning

confidence: 99%