Acta Medica Okayama volume73 issue4
2019-08 発行

Significance of Microcalcifications on Mammography in the Surgical Treatment of Breast Cancer Patients with a Preoperative Diagnosis of Ductal Carcinoma in Situ by Core Needle Biopsy

Isozaki, Hiroshi Department of Surgery, Oomoto Hospital
Yamamoto, Yasuhisa Department of Surgery, Oomoto Hospital
Murakami, Shigeki Department of Surgery, Oomoto Hospital
Matsumoto, Sasau Department of Surgery, Oomoto Hospital
Takama, Takehiro Department of Surgery, Oomoto Hospital
Publication Date
2019-08
Abstract
To clarify the surgical outcomes of breast cancer patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS) by core needle biopsy (CNB) (abbreviated as CNBDCIS), we retrospectively analyzed the cases of 131 patients with CNBDCIS who underwent surgery at Oomoto Hospital (32 total mastectomies, 99 conservative mastectomies). Our analysis of underestimation and predictors of invasive breast cancer of CNBDCIS revealed that the underestimation rate of CNBDCIS was 40.5% (53/131). A logistic regression analysis revealed that palpable tumors (yes to no, odds ratio [OR] 3.25), mammography (MMG) category group (category 4 or 5 to categories 1 , 2, or 3, OR 4.69) and MMG microcalcifications (no to yes, OR 0.24) were significant predictive factors for CNBDCIS invasion. In our analysis of the predictors of positive margins during CNBDCIS surgery, 36 (27.5%) of the 131 patients had positive margins after postoperative pathological examination. A logistic regression analysis revealed that the operative procedure (conservative surgery to total mastectomy, OR 21.4) and MMG microcalcifications (yes to no, OR 3.35) were significant factors related to positive margins during CNBDCIS surgery. Thus, MMG microcalcifications are a negative predictor of upgrading of CNBDCIS and a positive predictor of positive surgical margins for CNBDCIS.
Document Type
Original Article
Keywords
ductal carcinoma in situ
core needle biopsy
underestimation
positive margins
microcalcifications on mammography
Link to PubMed
Thumnail 73_4_349.pdf 1.98 MB