Highlights
- •Recurrence-free survival after propensity score matching did not differ between mIC and DCIS.
- •Microinvasion was not a significant independent prognostic factor.
- •Non-mass lesion at breast US, moderate/marked background parenchymal enhancement, and high peak enhancement at MRI were more frequent in the mIC than in the DCIS group.
Abstract
Introduction
The purpose of this study is to investigate the differences in clinical outcomes between
microinvasive carcinoma (mIC) and ductal carcinoma in situ (DCIS) and compare the imaging features of both using mammography, US and MRI.
Materials and methods
This retrospective study was approved by our institutional review board. Between January
2011 and December 2013, 516 women with mIC or DCIS confirmed by surgery were included.
Patients were matched with propensity score matching to compare recurrence-free survival
(RFS). RFS was compared using a Cox proportional hazards model. Imaging features were
also compared between the two groups.
Results
Among 516 women, 219 mIC and 297 DCIS tumors were identified. After matching, 132
women were allocated to each group. The mean follow-up duration was 80.2 months. In
the matched cohort, no statistically significant association was observed between
the DCIS and mIC groups in terms of total recurrence (hazard ratio [HR]: 1.7; 95%
confidence interval [CI]: 0.8–4.0; P = 0.19), local-regional recurrence (HR: 3.4; 95% CI: 0.9–12.3, P = 0.07), or contralateral recurrence (HR: 0.9; 95% CI: 0.3–2.8, P = 0.89). Non-mass lesions at US (P = 0.004), moderate or marked background parenchymal enhancement (P = 0.04), and higher peak enhancement (P = 0.02) at MRI were more commonly seen in the mIC group than in the DCIS group.
Conclusion
Microinvasive carcinomas are distinct from DCIS in terms of imaging features, but
no statistically significant association in recurrence survival.
Abbreviations:
BI-RADS (Breast Imaging Reporting and Data System), CI (confidence interval), DCIS (ductal carcinoma in situ), HER2 (human epidermal growth factor receptor 2), HR (hazard ratio), mIC (microinvasive carcinoma), NME (non-mass enhancement), PSM (propensity score matching), RFS (recurrence-free survival)Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical ImagingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ductal carcinoma in situ of the breast.N Engl J Med. 2004; 350: 1430-1441
- The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM.Ann. Surg. Oncol. 2010; 17: 1471-1474
- Microinvasive carcinoma of the breast.Pathol Oncol Res. 2008; 14: 105-111
- Breast Cancer (Version 1. 2021).https://www.nccn.org/professionals/physician_gls/pdf/breast.pdfDate: 2021Date accessed: February 5, 2021
- Extent of microinvasion in ductal carcinoma in situ is not associated with sentinel lymph node metastases.Ann Surg Oncol. 2014; 21: 3330-3335
- Clinicopathologic characteristics and molecular subtypes of microinvasive carcinoma of the breast.Tumour Biol. 2015; 36: 2241-2248
- Biologic behavior and long-term outcomes of breast ductal carcinoma in situ with microinvasion.Oncotarget. 2016; 7: 64182-64190
- The demographic features, clinicopathological characteristics and cancer-specific outcomes for patients with microinvasive breast cancer: a SEER database analysis.Sci Rep. 2017; 7: 42045
- Impact of microinvasion on breast cancer mortality in women with ductal carcinoma in situ.Breast Cancer Res Treat. 2018; 167: 787-795
- Microinvasive carcinoma versus ductal carcinoma in situ: a comparison of clinicopathological features and clinical outcomes.J Breast Cancer. 2018; 21: 197-205
- Surgical outcomes for ductal carcinoma in situ: impact of preoperative MRI.Radiology. 2020; 295: 296-303
- ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System.5th ed. American College of Radiology, Reston, VA2013
- Nonmass Findings at Breast US: Definition, Classifications, and Differential Diagnosis.Radiographics. 2020; 40: 326-335
- Differences in pathologic characteristics between ductal carcinoma in situ (DCIS), DCIS with microinvasion and DCIS with invasive ductal carcinoma.Int J Clin Exp Pathol. 2020; 13: 1066-1072
- Clinical characteristics of breast ductal carcinoma in situ with microinvasion: a narrative review.J Int Med Res. 2020; 48300060520969304
- Propensity score matching: a conceptual review for radiology researchers.Korean J Radiol. 2015; 16: 286-296
- MR features to suggest microinvasive ductal carcinoma of the breast: can it be differentiated from pure DCIS?.Acta Radiol. 2013; 54: 742-748
- MRI morphological classification of ductal carcinoma in situ (DCIS) correlating with different biological behavior.Eur J Radiol. 2012; 81: 214-217
- The role of MRI and clinicopathologic features in predicting the invasive component of biopsy-confirmed ductal carcinoma in situ.BMC Med Imaging. 2020; 20: 95
- Imaging features that distinguish pure ductal carcinoma in situ (DCIS) from DCIS with microinvasion.Mol Clin Oncol. 2019; 11: 313-319
- Sonographic features of ductal carcinoma in situ of the breast with microinvasion: correlation with clinicopathologic findings and biomarkers.J Ultrasound Med. 2015; 34: 1761-1768
- Clinical and imaging characteristics of breast ductal carcinoma in situ with microinvasion.J Appl Clin Med Phys. 2021; 22: 293-298
- Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols.J Magn Reson Imaging. 1999; 10: 223-232
- Preoperative dynamic breast magnetic resonance imaging kinetic features using computer-aided diagnosis: association with survival outcome and tumor aggressiveness in patients with invasive breast cancer.PloS one. 2018; 13e0195756
- Biological markers in DCIS and risk of breast recurrence: a systematic review.J Cancer. 2011; 2: 232-261
- Application of deep learning to identify ductal carcinoma in situ and microinvasion of the breast using ultrasound imaging.Quant Imaging Med Surg. 2022; 12: 4633-4646
Article info
Publication history
Published online: January 12, 2023
Accepted:
January 8,
2023
Received in revised form:
December 23,
2022
Received:
September 22,
2022
Identification
Copyright
© 2023 Published by Elsevier Inc.
