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Outcomes and imaging features of microinvasive carcinoma and ductal carcinoma in situ: Matched cohort study

  • Ga Young Yoon
    Affiliations
    Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, 38 Bangdong-gil, Sacheon-myeon, Gangneung-si, Gangwon-do 25440, Republic of Korea
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  • Woo Jung Choi
    Correspondence
    Corresponding author.
    Affiliations
    Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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  • Hak Hee Kim
    Affiliations
    Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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  • Joo Hee Cha
    Affiliations
    Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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  • Hee Jung Shin
    Affiliations
    Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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  • Eun Young Chae
    Affiliations
    Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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      Highlights

      • Recurrence-free survival after propensity score matching did not differ between mIC and DCIS (total recurrence, HR: 1.7; CI: 0.8-4.0, P = 0.19).
      • Microinvasion was not a significant independent prognostic factor after adjustment for confounding prognostic factors.
      • Non-mass lesion at breast US (P = 0.004), moderate/marked background parenchymal enhancement (P = 0.04), and high peak enhancement at MRI (P = 0.02) 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.

      Microabstract

      This study aimed to investigate the differences in clinical outcomes between microinvasive carcinoma (mIC) and ductal carcinoma in situ (DCIS) and compare imaging features. Five hundred sixteen women with mIC or DCIS were included. The results indicated that no statistically significant association was observed between the DCIS and mIC groups in terms of recurrence survival, but several imaging features were independent variables predicting mIC.

      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

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