Evans A J, Pinder S E, Snead D R, Wilson A R, Ellis I O, Elston C W
Department of Radiology, Nottingham City Hospital, UK.
Br J Cancer. 1997;75(4):542-4. doi: 10.1038/bjc.1997.94.
This study was carried out to assess the frequency of ductal carcinoma in situ (DCIS) occurring within and surrounding grade 3 invasive tumours and the effect of its detection on size and nodal stage of invasive carcinomas at mammographic detection. Grade 3 tumours with either no associated DCIS or DCIS only within the invasive component were significantly larger in size than tumours with surrounding DCIS (P < 0.02) and were less likely to be under or equal to 10 mm in size (0% or 13% vs 30% respectively, P < 0.02). Tumours with mammographic calcification were more likely to be less than or equal to 10 mm in size than non-calcific tumours (32% vs 11% respectively, P < 0.05). This was because of the high frequency of tumours less than or equal to 10 mm in size in the linear/branching calcification group. Tumours showing calcification without a mass also appear to be a group with good prognostic features, with a mean size of 13 mm, 33% being 10 mm or less in size and only 17% being node positive. We have found that the presence of surrounding DCIS enables earlier detection of grade 3 invasive carcinomas because of the presence of mammographically visible calcification. Detection of calcification suggestive of DCIS should remain an important part of mammographic screening.
本研究旨在评估3级浸润性肿瘤内部及周围原位导管癌（DCIS）的发生频率，以及其检测对乳腺钼靶检查时浸润性癌的大小和淋巴结分期的影响。无相关DCIS或仅在浸润成分内有DCIS的3级肿瘤，其大小显著大于有周围DCIS的肿瘤（P < 0.02），且大小小于或等于10 mm的可能性较小（分别为0%或13%对30%，P < 0.02）。乳腺钼靶有钙化的肿瘤比无钙化的肿瘤更可能小于或等于10 mm（分别为32%对11%，P < 0.05）。这是因为线性/分支状钙化组中大小小于或等于10 mm的肿瘤频率较高。无肿块的钙化肿瘤似乎也是一组预后良好的特征，平均大小为13 mm，33%大小为10 mm或更小，仅17%有淋巴结转移。我们发现，由于乳腺钼靶可见钙化的存在，周围DCIS的存在能够更早地检测出3级浸润性癌。检测提示DCIS的钙化应仍然是乳腺钼靶筛查的重要组成部分。
