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Breast Cancer. 2017 May;24(3):466-472. doi: 10.1007/s12282-016-0729-9. Epub 2016 Sep 17.

Mammographic extent of microcalcifications and oestrogen receptor expression affect preoperative breast carcinoma in situ size estimation.

Author information

1
Breast Surgery, Obstetrics and Gynaecology Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain. mvernet@hospitaldelmar.cat.
2
Consulting Service on Methodology for Biomedical Research, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader 88, 08003, Barcelona, Spain.
3
Obstetrics and Gynaecology Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.
4
Breast Surgery, Obstetrics and Gynaecology Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.
5
Breast Imaging, Radiology Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.
6
Pathology Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.

Abstract

BACKGROUND:

The aim of our study was to establish which clinical, radiologic and pathologic factors could predict the risk of under- and overestimation of the breast ductal carcinoma in situ (DCIS) size when preoperatively measuring the maximum mammographic extent of microcalcifications (MEM).

METHODS:

We made a retrospective review of patients with a DCIS treated in our Breast Unit between May 2005 and May 2012. Clinical, pathologic and radiologic data were evaluated as possible predictive factors for over- or underestimation of DCIS size when measuring MEM.

RESULTS:

We obtained precise measurements of MEM in 82 patients (84 DCIS lesions). Maximum MEM measurement correctly estimated maximum pathology size in 57 lesions (68.7 %). Patients with a correctly estimated DCIS, with an underestimated DCIS and with an overestimated DCIS significantly differed in DCIS ER expression (p = 0.022) and in maximum MEM measurement (p = 0.000). Constructing two ROC curves, we found that a maximum MEM measurement ≥25 mm and ER expression ≥90 % were both discrimination points for overestimation and ER ≤ 45 % was a discrimination point for underestimation. Using these cutoff points, we defined four groups of patients with different risks of over- and underestimation.

CONCLUSIONS:

Risk of over- or underestimation of DCIS size through MEM measurement depends on DCIS ER expression and MEM itself. Identifying which patients are at a significant risk of over- or underestimation could help the breast surgeon when discussing the surgical options with the patient.

KEYWORDS:

Ductal carcinoma in situ; Microcalcifications; Oestrogen receptor; Size estimation

PMID:
27639877
DOI:
10.1007/s12282-016-0729-9
[Indexed for MEDLINE]

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