Nicosia, L.; Giulio, G.; Bozzini, A.C.; Fanizza, M.; Ballati, F.; Rotili, A.; Lazzeroni, M.; Latronico, A.; Abbate, F.; Renne, G.; Addante, F.; Lucioni, M.; Cassano, E.; Mastropasqua, M.G. Complete Removal of the Lesion as A Guidance in the Management of Patients with Breast Ductal Carcinoma in Situ. Cancers2021, 13, 868.
Nicosia, L.; Giulio, G.; Bozzini, A.C.; Fanizza, M.; Ballati, F.; Rotili, A.; Lazzeroni, M.; Latronico, A.; Abbate, F.; Renne, G.; Addante, F.; Lucioni, M.; Cassano, E.; Mastropasqua, M.G. Complete Removal of the Lesion as A Guidance in the Management of Patients with Breast Ductal Carcinoma in Situ. Cancers 2021, 13, 868.
Nicosia, L.; Giulio, G.; Bozzini, A.C.; Fanizza, M.; Ballati, F.; Rotili, A.; Lazzeroni, M.; Latronico, A.; Abbate, F.; Renne, G.; Addante, F.; Lucioni, M.; Cassano, E.; Mastropasqua, M.G. Complete Removal of the Lesion as A Guidance in the Management of Patients with Breast Ductal Carcinoma in Situ. Cancers2021, 13, 868.
Nicosia, L.; Giulio, G.; Bozzini, A.C.; Fanizza, M.; Ballati, F.; Rotili, A.; Lazzeroni, M.; Latronico, A.; Abbate, F.; Renne, G.; Addante, F.; Lucioni, M.; Cassano, E.; Mastropasqua, M.G. Complete Removal of the Lesion as A Guidance in the Management of Patients with Breast Ductal Carcinoma in Situ. Cancers 2021, 13, 868.
Abstract
(1) Background: Considering highly selected patients with ductal carcinoma in situ (DCIS), active surveillance is a valid alternative to surgery. Our study is aimed at showing the reliability of post-biopsy complete lesion removal, documented by mammogram, as additional criterion to select these patients. (2) Methods: 2173 Vacuum Assisted Breast Biopsies (VABB) documented as DCIS have been reviewed. Surgery has been performed in all cases. We retrospectively collected the reports of post-VABB complete lesion removal and the histological results of the biopsy and surgery. We calculated the rate of upgrade of DCIS identified on VABB upon excision for patients with post-biopsy complete lesion removal and for those showing residual lesion. (3) Results: We observed 2173 cases of DCIS: 408 classified as low grade; 1262 as intermediate grade; 503 as high grade. The overall upgrading rate to invasive carcinoma was 15.2% (330/2173). The upgrade rate was significantly lower (8.2%) when considering patients showing mammographically documented complete removal of the lesion. (4) Conclusion: The absence of mammographically documented residual lesion following VABB is associated to a lower upgrading rate of DCIS to invasive carcinoma on surgical excision and should be considered when deciding the proper management DCIS diagnosis.
Keywords
Ductal carcinoma in situ (DCIS); Invasive Breast Carcinoma; Underestimation; Upgrade Rate; Vacuum assisted breast biopsy (VABB); Breast Microcalcifications; Active Surveillance.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Luca Nicosia
,
Matteo Lazzeroni
,
and Mauro Giuseppe Mastropasqua
*