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Chronological Trends of Breast Ductal Carcinoma In Situ: Clinical, Radiologic, and Pathologic Perspectives

 Si Eun Lee  ;  Ha Yan Kim  ;  Jung Hyun Yoon  ;  Eun-Kyung Kim  ;  Jee Ye Kim  ;  Min Jung Kim  ;  Ga Ram Kim  ;  Youngjean Vivian Park  ;  Hee Jung Moon 
 ANNALS OF SURGICAL ONCOLOGY, Vol.28(13) : 8699-8709, 2021-12 
Journal Title
Issue Date
Breast / diagnostic imaging ; Breast Neoplasms* / diagnostic imaging ; Breast Neoplasms* / surgery ; Carcinoma in Situ* ; Carcinoma, Ductal, Breast* / diagnostic imaging ; Carcinoma, Ductal, Breast* / surgery ; Carcinoma, Intraductal, Noninfiltrating* / diagnostic imaging ; Carcinoma, Intraductal, Noninfiltrating* / surgery ; Female ; Humans ; Mammography ; Retrospective Studies
Background: Because no prior studies have evaluated the chronological trends of ductal carcinoma in situ (DCIS) despite the increasing number of surgeries performed for DCIS, this study analyzed how the clinical, radiologic, and pathologic characteristics of DCIS changed during a 10-year period.

Methods: Of 7123 patients who underwent primary breast cancer surgery at a single institution from 2006 to 2015, 792 patients with pure DCIS were included in this study. The chronological trends of age, symptoms, method for detecting either mammography or ultrasonography, tumor size, nuclear grade, comedonecrosis, and molecular markers were calculated using Poisson regression for all patients and asymptomatic patients.

Results: During 10 years, DCIS surgery rates significantly increased (p < 0.001). Despite the high percentage of DCIS detected on mammography, the detection rate for DCIS by mammography significantly decreased (97.3% in 2006 to 67.6% in 2015; p = 0.025), whereas the detection rate by ultrasound significantly increased (2.7% to 31.0%; p < 0.001). Conservation surgery rates (odds ratio [OR], 1.058), low-to-intermediate nuclear grade rates (OR, 1.069), and the absence of comedonecrosis (OR, 1.104) significantly increased over time (all p < 0.05). Estrogen receptor (ER) negativity (OR, 0.935) and human epidermal growth factor receptor 2 (HER2) positivity rates (OR, 0.953) significantly decreased (all p < 0.05). The same trends were observed for the 613 asymptomatic patients.

Conclusion: The rate of DCIS detected on ultrasound only significantly increased during 10 years. Low-to-intermediate nuclear grade rates significantly increased, whereas ER negativity and HER2 positivity rates significantly decreased during the same period. These findings suggest that DCIS detected on screening ultrasound is less aggressive than DCIS detected on mammography.
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1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ga Ram(김가람) ORCID logo https://orcid.org/0000-0002-4481-5792
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Kim, Jee Ye(김지예) ORCID logo https://orcid.org/0000-0003-3936-4410
Kim, Ha Yan(김하얀)
Park, Vivian Youngjean(박영진) ORCID logo https://orcid.org/0000-0002-5135-4058
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
Lee, Si Eun(이시은) ORCID logo https://orcid.org/0000-0002-3225-5484
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