51 Ductal Carcinoma In Situ With Microinvasion on Biopsy—What Are the Predictors of Upstaging?

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement41st Annual Miami Breast Cancer Conference® - Abstracts
Volume 38
Issue 4
Pages: 58-60

Background

Ductal carcinoma in situ with microinvasion (DCISM) follows the same management as used for DCIS. Breast-conserving surgery without sentinel lymph node biopsy is indicated, as the risk of upstaging to invasive carcinoma (> 1 mm) is low. Interestingly, it is reported that approximately 30% of patients with DCISM on biopsy will upstage to invasive cancer, creating a challenge in balancing the risk of overtreatment to undertreatment. The aim of this study is to identify risk factors for upstaging of DCISM to invasive disease (> 1 mm).

Methods

A retrospective chart review of women over the age of 18 years who had a DCISM on initial breast biopsy from 2013 to 2019 at a large single-center institution was performed. Demographic, clinical, histologic, and radiographic data were collected. Descriptive statistics were used to report means and standard deviations. Fisher exact test was used for categorical variables, and the Student t test was used for numerical variables to identify variables that may be associated with final pathologic upstaging.

Results

Patient Characteristics

Patient Characteristics

A total of 46 women were identified in the age range of 41 to
76 years. Sixteen patients (35%) with DCISM on biopsy were upstaged to invasive carcinoma (> 1 mm). Upstaging to invasive disease was correlated with palpable mass (OR, 9.33; CI, 1.23-117.3; P = .0468), hormone receptor negativity on biopsy (OR, 4.22; CI, 1.19-13.5; P = .049), and size on diagnostic mammogram of at least 3.5 cm (OR, 5.00; CI, 1.095-17.56; P = .0367).

Radiographic findings

Radiographic findings

Conclusions

We report a similar rate of upstaging as previous studies; however, to our knowledge, we are the first to report associated risk factors with upstaging to invasive carcinoma (> 1 mm) from DCISM on biopsy. This can guide surgeons to identify which patients may require a sentinel lymph node biopsy at the time of breast-conserving surgery.

Articles in this issue

38 Influence of Race on Attainment of Textbook Oncologic Outcome Following Modified Radical Mastectomy for Breast Cancer
38 Influence of Race on Attainment of Textbook Oncologic Outcome Following Modified Radical Mastectomy for Breast Cancer
39 The Influence of Reconstruction Type on Outcomes in Women Undergoing Mastectomy With Immediate Reconstruction:  A Nationwide Study
39 The Influence of Reconstruction Type on Outcomes in Women Undergoing Mastectomy With Immediate Reconstruction: A Nationwide Study
40 Ethnic Disparities in Complication Rates and Outcomes  of Nipple-Sparing Mastectomy:  A Comprehensive Analysis
40 Ethnic Disparities in Complication Rates and Outcomes of Nipple-Sparing Mastectomy: A Comprehensive Analysis
41 A Case Series of Sarcomas
41 A Case Series of Sarcomas
42 Transitional Lymphedema: Understanding the Temporal Dynamics Post-Axillary Surgery
42 Transitional Lymphedema: Understanding the Temporal Dynamics Post-Axillary Surgery
43 Impact of Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) on Postoperative Complication Rates in Mastectomy With Immediate Prosthetic-Based Breast Reconstruction
43 Impact of Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) on Postoperative Complication Rates in Mastectomy With Immediate Prosthetic-Based Breast Reconstruction
44 Variant of Uncertain Significance (VUS) Genetic Testing Results and Mastectomy Choice in Lumpectomy-Eligible Patients
44 Variant of Uncertain Significance (VUS) Genetic Testing Results and Mastectomy Choice in Lumpectomy-Eligible Patients
45 Application of the 7-Gene Biosignature in Palpable Versus Nonpalpable Ductal Carcinoma In Situ in a Black Patient Population: Does Palpability Suggest a More Aggressive Genomic Risk?
45 Application of the 7-Gene Biosignature in Palpable Versus Nonpalpable Ductal Carcinoma In Situ in a Black Patient Population: Does Palpability Suggest a More Aggressive Genomic Risk?
46 Comparative Analysis of Breast Conserving Therapy vs Mastectomy in Multifocal and Multicentric Breast Cancer: A Review of the Literature
46 Comparative Analysis of Breast Conserving Therapy vs Mastectomy in Multifocal and Multicentric Breast Cancer: A Review of the Literature
47 Can We Identify Factors That Predict DCIS Upgrade to Invasive Cancer at Mastectomy?
47 Can We Identify Factors That Predict DCIS Upgrade to Invasive Cancer at Mastectomy?
48 The Era ‘or Error’ of Second Localization Procedures
48 The Era ‘or Error’ of Second Localization Procedures
49 The Influence of Race on Complications in Breast Conservation Surgery: A Single Institution Study
49 The Influence of Race on Complications in Breast Conservation Surgery: A Single Institution Study
51 Ductal Carcinoma In Situ With Microinvasion on Biopsy—What Are the Predictors of Upstaging?
51 Ductal Carcinoma In Situ With Microinvasion on Biopsy—What Are the Predictors of Upstaging?
52 UK Experience of Non-Radioisotope, Non-Magnetic Guided Breast Wide Local Excision and Sentinel Node Biopsy
52 UK Experience of Non-Radioisotope, Non-Magnetic Guided Breast Wide Local Excision and Sentinel Node Biopsy
53 The Utility of Sentinel Lymph Node Biopsy in High-Grade Ductal Carcinoma In Situ
53 The Utility of Sentinel Lymph Node Biopsy in High-Grade Ductal Carcinoma In Situ
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