TABLE 1.
Clinical presentation, imaging, and biopsy characteristics by extent of the DCISM lesion
| DCISM suspected [n = 105] | DCISM definite 1 focus [n =175] | DCISM definite >1 focus 1 biopsy [n = 67] | DCISM definite >1 focus >1 biopsy [n = 22] | p-Value | DCISM definite total [n = 264] | p-Value | |
|---|---|---|---|---|---|---|---|
| Clinical characteristics | |||||||
| Age, years [median (IQR)] | 57 (48–65) | 53 (46–61) | 54 [47–62] | 55 (48–61) | 0.20 | 53 (47–61) | 0.04 |
| Palpable mass | 3 (3) | 17 (10) | 3 (5) | 2 (9) | 0.13 | 22 (8) | 0.06 |
| Imaging characteristics | |||||||
| Diagnosed by: | 0.005 | 0.004 | |||||
| Mammogram | 93 (89) | 137 (78) | 52 (78) | 12 (54) | 201 (76) | ||
| Ultrasound | 2 (29) | 6 (3) | 2 (3) | 0 (0) | 8 (3) | ||
| MRI | 4 (48) | 11 (6) | 4 (6) | 1 (5) | 16 (6) | ||
| Multiple | 6 (67) | 21 (11) | 9 (12) | 9 (41) | 39 (15) | ||
| Mass or asymmetry on imaging | 18 (17) | 31 (18) | 19 (28) | 5 (23) | 0.25 | 55 (21) | 0.42 |
| Extent of calcificationsa | 0.13 | 0.67 | |||||
| Small cluster(s) or <1 cm | 23 (23) | 44 (28) | 17 (30) | 2 (10) | 63 (27) | ||
| 1 to <5 cm | 47 (49) | 74 (47) | 28 (49) | 9 (43) | 111 (47) | ||
| 5 to <10 cm | 19 (20) | 22 (14) | 10 (18) | 7 (33) | 39 (17) | ||
| ≥10 cm or diffuse | 2 (2) | 7 (5) | 1 (2) | 3 (14) | 11 (5) | ||
| Calcifications present but no size provided | 6 (6) | 9 (6) | 1 (2) | 0 (0) | 10 (4) | ||
| Biopsy guidance | <0.001 | 0.02 | |||||
| Stereotactic | 95 (91) | 136 (78) | 53 (79) | 14 (64) | 203 (77) | ||
| Ultrasound | 7 (7) | 29 (17) | 9 (13) | 0 (0.0) | 38 (14) | ||
| MRI | 3 (3) | 9 (5) | 5 (8) | 1 (5) | 15 (6) | ||
| Multiple biopsy types | 0 (0.0) | 1 (1) | 0 (0.0) | 7 (32) | 8 (3) | ||
| Pathologic characteristics on core needle biopsy | |||||||
| Necrosisb | 93 (93) | 149 (96) | 58 (92) | 17 (90) | 0.61 | 224 (94) | 0.70 |
| Nuclear gradeb,c | 0.008 | 0.19 | |||||
| Low | 3 (3) | 7 (4) | 1 (25) | 0 (0) | 8 (3) | ||
| Low to intermediate | 5 (5) | 7 (4) | 4 (6) | 0 (0) | 11 (4) | ||
| Intermediate | 32 (31) | 36 (21) | 11 (17) | 3 (14) | 50 (19) | ||
| Intermediate to high | 17 (16) | 43 (25) | 7 (11) | 4 (18) | 54 (21) | ||
| High | 47 (45) | 80 (46) | 43 (65) | 15 (6) | 138 (52) | ||
| Lymphocytic reaction | 5 (5) | 7 (4) | 5 (8) | 1 (5) | 0.74 | 5 (5) | 0.95 |
| Presence of calcifications | 90 (94) | 149 (97) | 50 (94) | 21 (100) | 0.48 | 220 (97) | 0.27 |
| Architectureb | 0.31 | 0.60 | |||||
| Solid | 32 (31) | 57 (33) | 22 (33) | 4 (18) | 83 (32) | ||
| Cribriform | 8 (8) | 9 (5) | 3 (5) | 0 (0) | 12 (5) | ||
| Micropapillary | 0 (0) | 2 (1) | 1 (2) | 0 (0) | 3(1) | ||
| Papillary | 0 (0) | 0 (0.0) | 2 (3) | 0 (0) | 2 (18) | ||
| Tubular | 0 (0) | 1 (1) | 0 (0) | 0 (0) | 1 (0.4) | ||
| Mixed | 63 (61) | 104 (60) | 38 (58) | 18 (82) | 160 (61) | ||
| Treatment | |||||||
| Surgical management | 0.002 | 0.72 | |||||
| Lumpectomy | 57 (54) | 97 (55) | 38 (57) | 3 (14) | 138 (52) | ||
| Mastectomy | 48 (46) | 78 (45) | 29 (43) | 19 (86) | 126 (48) | ||
| Axillary evaluation | <0.001 | <0.001 | |||||
| No axillary evaluation | 24 (23) | 12 (7) | 3 (5) | 0 (0) | 15 (6) | ||
| SLNB only | 81 (77) | 154 (88) | 58 (87) | 18 (82) | 230 (87) | ||
| SLNBandALND | 0 (0) | 9 (5) | 6 (9) | 4 (18) | 19 (7) |
Data are expressed as n (%) unless otherwise specified
Percentages are rounded
DCISM ductal carcinoma in situ with microinvasion, IQR interquartile range, SLNB sentinel lymph node biopsy, ALND axillary lymph node dissection, MRI magnetic resonance imaging
a
Data on the extent of calcifications were missing in 9 patients (2.4%), while the 29 remaining patients had no calcifications
b
Data on necrosis were missing in 31 patients (8%; on nuclear grade in 4 patients (1%) and on architecture in 5 patients (1%)