Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1980 Aug;192(2):139–147. doi: 10.1097/00000658-198008000-00001

Noninvasive Breast Carcinoma: Results of a National Survey by the American College of Surgeons

Dutzu Rosner, Ramez N Bedwani, Josef Vana, Harvey W Baker, Gerald P Murphy
PMCID: PMC1344842  PMID: 6250497

Abstract

This study evaluates the data of noninvasive (in situ) lobular (ISLC) and ductal (ISDC) carcinoma, collected from 498 hospitals in a National Breast Cancer Survey, carried out by the American College of Surgeons in 1978. ISLC and ISDC were identified in 323 (3.2%) of 10,054 female patients with lobular and ductal carcinoma, of the total of 23,972 patients with histologically proven breast cancer surveyed (1.4%). The frequency of ISLC was significantly higher (18.5%) than ISDC (2.1%) suggesting a less agressive nature of ISLC, with a slower progression to invasion than ISDC. There was a different age distribution of ISLC and ISDC: about 80% of ISLC and 50% of ISDC were diagnosed in patients who were less than 54 years old, and the incidence showed a marked decrease in the older age groups in ISLC, whereas the incidence remained high in the following decade in ISDC. In this series there was a distinctly better five-year cure rate in the patients with ISLC (83.5%) than in the patients with ISDC (68.8%), in spite of the fact that radical surgery was performed more frequently in ISDC (67.8%) than ISLC (36.3%). The recurrence rate was five times higher (10.5%) in ISDC than in ISLC (2.5%). In black patients the recurrence rate (21.3%) was significantly higher in ISDC than in white patients (9.3%). In the present study there were no statistically significant differences in the five-year cure and recurrence rate in patients with noninvasive carcinoma, treated by more conservative procedures (72.9% and 8.5%) and those treated by more extensive surgeries (76.2% and 7.7%). The results of this study suggests that the biologic behavior of ISLC and ISDC may be different with regard to their propensity to invade and their overall prognosis. In contrast, the infiltrative form of lobular and ductal carcinoma, were found to have the same prognosis, regardless of the type of operative procedure performed.

Full text

PDF
143

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersen J. A. Lobular carcinoma in situ of the breast. An approach to rational treatment. Cancer. 1977 Jun;39(6):2597–2602. doi: 10.1002/1097-0142(197706)39:6<2597::aid-cncr2820390644>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  2. Ashikari R., Hajdu S. I., Robbins G. F. Intraductal carcinoma of the breast. (1960-1969). Cancer. 1971 Nov;28(5):1182–1187. doi: 10.1002/1097-0142(1971)28:5<1182::aid-cncr2820280515>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  3. Benfield J. R., Fingerhut A. G., Warner N. E. Lobular carcinoma of the breast-1969. A therapeutic proposal. Arch Surg. 1969 Aug;99(2):129–140. doi: 10.1001/archsurg.1969.01340140001001. [DOI] [PubMed] [Google Scholar]
  4. Betsill W. L., Jr, Rosen P. P., Lieberman P. H., Robbins G. F. Intraductal carcinoma. Long-term follow-up after treatment by biopsy alone. JAMA. 1978 May 5;239(18):1863–1867. doi: 10.1001/jama.239.18.1863. [DOI] [PubMed] [Google Scholar]
  5. Brown P. W., Silverman J., Owens E., Tabor D. C., Terz J. J., Lawrence W., Jr Intraductal "noninfiltrating" carcinoma of the breast. Arch Surg. 1976 Oct;111(10):1063–1067. doi: 10.1001/archsurg.1976.01360280021003. [DOI] [PubMed] [Google Scholar]
  6. Davis R. P., Nora P. F., Kooy R. G., Hines J. R. Experience with lobular carcinoma of the breast. Emphasis on recent aspects of management. Arch Surg. 1979 Apr;114(4):485–488. doi: 10.1001/archsurg.1979.01370280139021. [DOI] [PubMed] [Google Scholar]
  7. Farrow J. H. Clinical considerations and treatment of in situ lobular breast cancer. Am J Roentgenol Radium Ther Nucl Med. 1968 Mar;102(3):652–656. doi: 10.2214/ajr.102.3.652. [DOI] [PubMed] [Google Scholar]
  8. Farrow J. H. Current concepts in the detection and treatment of the earliest of the early breast cancers. Cancer. 1970 Feb;25(2):468–477. doi: 10.1002/1097-0142(197002)25:2<468::aid-cncr2820250226>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  9. Fisher E. R., Fisher B. Lobular carcinoma of the breast: an overview. Ann Surg. 1977 Apr;185(4):377–385. doi: 10.1097/00000658-197704000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Foote F. W., Stewart F. W. Lobular carcinoma in situ: A rare form of mammary cancer. Am J Pathol. 1941 Jul;17(4):491–496.3. doi: 10.3322/canjclin.32.4.234. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gallager H. S., Martin J. E. Early phases in the development of breast cancer. Cancer. 1969 Dec;24(6):1170–1178. doi: 10.1002/1097-0142(196912)24:6<1170::aid-cncr2820240615>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  12. Giordano J. M., Klopp C. T. Lobular carcinoma in situ: incidence and treatment. Cancer. 1973 Jan;31(1):105–109. doi: 10.1002/1097-0142(197301)31:1<105::aid-cncr2820310114>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  13. Haagensen C. D., Lane N., Lattes R., Bodian C. Lobular neoplasia (so-called lobular carcinoma in situ) of the breast. Cancer. 1978 Aug;42(2):737–769. doi: 10.1002/1097-0142(197808)42:2<737::aid-cncr2820420247>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  14. Haagensen C. D., Lane N., Lattes R. Neoplastic proliferation of the epithelium of the mammary lobules: adenosis, lobular neoplasia, and small cell carcinoma. Surg Clin North Am. 1972 Apr;52(2):497–524. doi: 10.1016/s0039-6109(16)39706-7. [DOI] [PubMed] [Google Scholar]
  15. Herrmann J. B. Treatment of in situ mammary carcinoma. Int Surg. 1972 Feb;57(2):127–129. [PubMed] [Google Scholar]
  16. Hutter R. V., Foote F. W., Jr Lobular carcinoma in situ. Long term follow-up. Cancer. 1969 Nov;24(5):1081–1085. doi: 10.1002/1097-0142(196911)24:5<1081::aid-cncr2820240534>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  17. Lewison E. F., Finney G. G., Jr Lobular carcinoma in situ of the breast. Surg Gynecol Obstet. 1968 Jun;126(6):1280–1286. [PubMed] [Google Scholar]
  18. Martin J. E., Gallager H. S. Mammographic diagnosis of minimal breast cancer. Cancer. 1971 Dec;28(6):1519–1526. doi: 10.1002/1097-0142(197112)28:6<1519::aid-cncr2820280627>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  19. McDivitt R. W., Hutter R. V., Foote F. W., Jr, Stewart F. W. In situ lobular carcinoma. A prospective follow-up study indicating cumulative patient risks. JAMA. 1967 Jul 10;201(2):82–86. doi: 10.1001/jama.201.2.82. [DOI] [PubMed] [Google Scholar]
  20. Millis R. R., Thynne G. S. In situ intraduct carcinoma of the breast: a long term follow-up study. Br J Surg. 1975 Dec;62(12):957–962. doi: 10.1002/bjs.1800621209. [DOI] [PubMed] [Google Scholar]
  21. Newman W. Lobular carcinoma of the female breast. Report of 73 cases. Ann Surg. 1966 Aug;164(2):305–314. doi: 10.1097/00000658-196608000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Ozzello L., Sanpitak P. Epithelial-stromal junction of intraductal carcinoma of the breast. Cancer. 1970 Dec;26(6):1186–1198. doi: 10.1002/1097-0142(197012)26:6<1186::aid-cncr2820260603>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  23. Rosen P. P., Senie R., Schottenfeld D., Ashikari R. Noninvasive breast carcinoma: frequency of unsuspected invasion and implications for treatment. Ann Surg. 1979 Mar;189(3):377–382. doi: 10.1097/00000658-197903000-00021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Smart C. R., Myers M. H., Gloeckler L. A. Implications from SEER data on breast cancer management. Cancer. 1978 Mar;41(3):787–789. doi: 10.1002/1097-0142(197803)41:3<787::aid-cncr2820410301>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  25. Sommers S. C. Histologic changes in incipient carcinoma of the breast. Cancer. 1969 Apr;23(4):822–825. doi: 10.1002/1097-0142(196904)23:4<822::aid-cncr2820230416>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  26. Warner N. E. Lobular carcinoma of the breast. Cancer. 1969 Apr;23(4):840–846. doi: 10.1002/1097-0142(196904)23:4<840::aid-cncr2820230418>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  27. Wheeler J. E., Enterline H. T., Roseman J. M., Tomasulo J. P., McIlvaine C. H., Fitts W. T., Jr, Kirshenbaum J. Lobular carcinoma in situ of the breast. Long-term followup. Cancer. 1974 Sep;34(3):554–563. doi: 10.1002/1097-0142(197409)34:3<554::aid-cncr2820340313>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES