S Shanthala, Amirtham Usha, Gopal Champaka, Arjun Ravi, Jacob Linu
Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore City, Karnataka India.
Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore City, Karnataka India.
Indian J Surg Oncol. 2025 Apr;16(2):508-515. doi: 10.1007/s13193-023-01853-2. Epub 2023 Dec 4.
Ductal Carcinoma In Situ (DCIS) is not an obligate precursor to invasive breast cancer and can exhibit variations in clinical presentation, genetics, biomarkers, and morphological features. There are contrasting views in literature with regard to prognostic significance of DCIS component in invasive cancer. Hence, this study aimed to evaluate how the co-occurrence of DCIS affects the prognosis of people with invasive breast cancer (IBC). A retrospective nested cohort observational study of patients with invasive breast cancer with and without DCIS component was conducted to compare the types of metastases developed on the subsequent follow-up, treatment details, event free survival and other histopathological parameters. There was a significant difference ( = 0.014) in the mean age at diagnosis between patients of IBC with concurrent DCIS (45 ± 11.18 years) and those who had IBC alone (53.24 ± 10.45 years). Invasive cancer with concurrent DCIS component tends to be more common in patients less than 50 years age group ( = 0.03). Majority (75.56%) of the patients were in post-menopausal stage. Patients with concurrent DCIS had higher frequencies of tumors of T1/ T2 stages and zero nodal status. Higher frequencies of local recurrence and visceral metastases were observed in patients with DCIS component compared to patients with IBC alone. Majority had received complete treatment. Longer event free survival was noted in patients with DCIS component compared to those with IBC alone. Our study demonstrated significant association of concurrent DCIS component with mean age at diagnosis in patients with invasive breast cancer. Although a trend towards favorable tumor profile was observed, larger prospective studies are required to enhance the statistical power of our findings. In view of its impact on clinical outcome, it is important to risk stratify invasive breast cancer based on the features of concurrent DCIS component.
导管原位癌（DCIS）并非浸润性乳腺癌的必然前驱病变，其临床表现、遗传学、生物标志物及形态学特征均可出现变异。关于DCIS成分在浸润性癌中的预后意义，文献中有不同观点。因此，本研究旨在评估DCIS的同时存在如何影响浸润性乳腺癌（IBC）患者的预后。对有或无DCIS成分的浸润性乳腺癌患者进行了一项回顾性巢式队列观察研究，以比较后续随访中发生的转移类型、治疗细节、无事件生存期及其他组织病理学参数。IBC合并DCIS患者的诊断时平均年龄（45±11.18岁）与单纯IBC患者（53.24±10.45岁）之间存在显著差异（P = 0.014）。合并DCIS成分的浸润性癌在年龄小于50岁的患者中更为常见（P = 0.03）。大多数患者（75.56%）处于绝经后阶段。合并DCIS的患者T1/T2期肿瘤及无淋巴结转移状态的频率更高。与单纯IBC患者相比，合并DCIS成分的患者局部复发和内脏转移的频率更高。大多数患者接受了完整治疗。与单纯IBC患者相比，合并DCIS成分的患者无事件生存期更长。我们的研究表明，DCIS成分与浸润性乳腺癌患者的诊断时平均年龄显著相关。尽管观察到有肿瘤特征良好的趋势，但需要更大规模的前瞻性研究来增强我们研究结果的统计学效力。鉴于其对临床结局的影响，基于合并DCIS成分的特征对浸润性乳腺癌进行风险分层很重要。
