Clinical Features and Pathological Characteristics of Ductal Carcinoma in Situ of the Breast in Mastectomy and Breast Conservative Surgery

ABSTRACT

PURPOSE: Breast conservative surgery (BCS) with adjuvant radiation has recently shown similarly good treatment results in patients with early invasive breast cancer, as a mastectomy. However, a mastectomy is performed in some patients with ductal carcinoma in situ (DCIS) for many reasons. In order to compare a mastectomy with breast conservative surgery, the relationship between the clinical and pathological features, the prognoses, and factors affecting the choice of surgical method were evaluated. METHODS: A total 217 patients who underwent an operation for DCIS at Samsung Medical Center, between November 1994 and February 2002, were enrolled for this study. The patients' medical records were retrospectively reviewed for the clinical, radiological and pathological findings. RESULTS: The mean age of the mastectomy and conservative surgery groups were 47.5 and 45.0 years, respectively. A mastectomy was performed in 124 patients (57.1%), and breast conservative surgery was received by 93. The major causes for a mastectomy were a subareolar mass or calcification and multiple masses or calcifications. The median tumor size in the mastectomy group was 2.41cm, which was larger than the 1.05 cm in the BCS group (P<0.05). Recurrence was found in four patients during the follow up period (at a median of 34.0 months), but no additional recurrence was found after local excision or mastectomy for the recurred tumors. CONCLUSION: The patients in the mastectomy group were older, and their tumor size larger than the conservative surgery group. 57.1% of the patients, with nipple-areolar complex invasion, had a subareolar mass or calcification as the cause for their mastectomy, therefore, it is suggested that the patients with a subareolar mass or calcification should undergo a mastectomy for the complete excision of the tumor.