Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Two Decades of Experience with Ductal Carcinoma in Situ of the Breast in the Cancer Institute of Tehran, Iran

  • Omranipour, Ramesh (Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences) ;
  • Alipour, Sadaf (Surgery Department, Arash Women's Hospital) ;
  • Hadji, Maryam (Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences) ;
  • Bagheri, Khojasteh (Research Development Center, Arash Women's Hospital)
  • Published : 2014.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Breast cancer screening and higher quality mammography have resulted in an increase in the diagnosis of ductal carcinoma in situ worldwide. We compared the incidence and other factors in our cases of ductal carcinoma in situ between two recent decades. Materials and Methods: Medical records of cases of ductal carcinoma in situ who had been admitted to the surgery wards of the Cancer Institute of Tehran, Iran were evaluated from March 1993 to March 2003 as phase 1, and from April 2003 to April 2013 as phase 2. Results: Ratio of ductal carcinoma in situ to overall breast cancer was 1.27 and 3.93 in phases 1 and 2, respectively. Rates of excisional or incisional biopsies versus core needle biopsies and clinically versus mammographically detected cases as well as median size of tumors dropped between the 2 phases while a substantial rise in the number of patients attending for screening was seen in this time period. Surgical treatments followed a trend from modified radical mastectomy and axillary lymphatic dissection toward breast conserving surgery and sentinel node dissection or no axillary intervention. Conclusions: Our study shows a considerable trend toward earlier detection of breast cancer and evolution of treatment strategies toward standard less invasive surgery of DCIS in Iran.

Keywords

References

  1. Atoum MF, Hourani HM, Shoter A, Al-Raheem SN, Al Muhrib TK (2010). Tnm staging and classification (familial and nonfamilial) of breast cancer in jordanian females. Indian J Cancer, 47, 194-8. https://doi.org/10.4103/0019-509X.63022
  2. Aytac B, Sahsine T, Erturk FY, Kahveci R, Gokgoz S (2013). Evaluation of incidence and histolopathological findings of breast lesions in reduction mammoplasty specimens: Uludag university experience. J Pak Med Assoc, 63, 878-81.
  3. Badruddoja M (2012). Ductal carcinoma in situ of the breast: A surgical perspective. Int J Surg Oncol, 2012, 761364.
  4. Bleyer A, Welch HG (2012). Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med, 367, 1998-2005. https://doi.org/10.1056/NEJMoa1206809
  5. Brennan ME, Turner RM, Ciatto S, et al (2011). Ductal carcinoma in situ at core-needle biopsy: Meta-analysis of underestimation and predictors of invasive breast cancer. Radiology, 260, 119-28. https://doi.org/10.1148/radiol.11102368
  6. Chan LK, Lam HS, Chan ES, et al (1998). Mammogram screening of chinese women in kwong wah hospital, hong kong. Australas Radiol, 42, 6-9. https://doi.org/10.1111/j.1440-1673.1998.tb00554.x
  7. Choi DX, Van Zee KJ (2012). Memorial sloan-kettering cancer center: two decades of experience with ductal carcinoma in situ of the breast. Int J Surg Oncol, 2012, 723916.
  8. Chua CL, Tan K, Chiang G, Soo KC, Low CH (1992). Breast carcinoma-in-situ: An emerging problem in singapore. Singapore Med J, 33, 383-5.
  9. Chuwa EW, Tan VH, Tan H, et al (2008). Treatment for ductal carcinoma in situ in an asian population: Outcome and prognostic factors. ANZ J Surg, 78, 42-8. https://doi.org/10.1111/j.1445-2197.2007.04354.x
  10. Estevez LG, Alvarez I, Segui MA, et al (2010). Current perspectives of treatment of ductal carcinoma in situ. Cancer Treat Rev, 36, 507-17. https://doi.org/10.1016/j.ctrv.2010.03.007
  11. Fortunato L, Poccia I, De Paula U, Santini E (2012). Ductal carcinoma in situ: what can we learn from clinical trials? Int J Surg Oncol, 2012, 296829.
  12. Harirchi I, Kolahdoozan S, Karbakhsh M, et al (2011). Twenty years of breast cancer in iran: downstaging without a formal screening program. Ann Oncol, 22, 93-7. https://doi.org/10.1093/annonc/mdq303
  13. Hunt Kk NL, Copeland Iii Em, Bland Kl (2010). The breast, in: A. D. Brunicardi Fc, Billiar Tr, Dunn Dl, Hunter Jg, Matthews Jb, Pollock Re (Ed.) Schwartz's Principles of Surgery. 9th ed. (USA, McGraw-Hill), 424-6.
  14. Ikeda T, Jinno H, Matsui A, et al (2002). Overview: current status of breast conserving therapy in japan. Biomed Pharmacother, 56, 182-6. https://doi.org/10.1016/S0753-3322(02)00280-9
  15. Izumori A, Takebe K, Sato A (2010). Ultrasound findings and histological features of ductal carcinoma in situ detected by ultrasound examination alone. Breast Cancer, 17, 136-41. https://doi.org/10.1007/s12282-009-0134-8
  16. Jara-Lazaro AR, Thilagaratnam S, Tan H (2010). Breast cancer in singapore: Some perspectives. Breast Cancer, 17, 23-8. https://doi.org/10.1007/s12282-009-0155-3
  17. Jemal A, Siegel R, Ward E, et al (2009). Cancer statistics, 2009. CA Cancer J Clin, 59, 225-49. https://doi.org/10.3322/caac.20006
  18. Kayani N, Bhurgri Y (2005). Ductal carcinoma in situ (DCIS) in Karachi. J Pak Med Assoc, 55, 199-202.
  19. Kokubo M, Mitsumori M, Kanehira K, et al (2001). Results of breast-conserving therapy for ductal carcinoma in situ: the Kyoto University experiences. Breast Cancer, 8, 153-7. https://doi.org/10.1007/BF02967495
  20. Lambert K, Patani N, Mokbel K (2012). Ductal carcinoma in situ: recent advances and future prospects. Int J Surg Oncol, 2012, 347385.
  21. Lee RJ, Vallow LA, Mclaughlin SA, et al (2012). Ductal carcinoma in situ of the breast. Int J Surg Oncol, 2012,123549.
  22. Leeper AD, Dixon JM (2011). DCIS of the breast: Are we overdiagnosing it? Are we over-treating it? Maturitas, 68, 295-6. https://doi.org/10.1016/j.maturitas.2010.12.008
  23. Livaudais JC, Hwang ES, Karliner L, et al (2012). Adjuvant hormonal therapy use among women with ductal carcinoma in situ. J Womens Health, 21, 35-42. https://doi.org/10.1089/jwh.2011.2773
  24. Lui CY, Lam HS, Chan LK, et al (2007). Opportunistic breast cancer screening in hong kong; a revisit of the kwong wah hospital experience. Hong Kong Med J, 13, 106-13.
  25. Macmahon B, Morrison AS, Ackerman LV, et al (1973). Histologic characteristics of breast cancer in boston and tokyo. Int J Cancer, 11, 338-44. https://doi.org/10.1002/ijc.2910110211
  26. Mun HS, Shin HJ, Kim HH, Cha JH, Kim H (2013). Screeningdetected calcified and non-calcified ductal carcinoma in situ: Differences in the imaging and histopathological features. Clin Radiol, 68, 27-35. https://doi.org/10.1016/j.crad.2012.05.009
  27. Parikh RR, Haffty BG, LanninD, Moran MS (2012.) Ductal carcinoma in situ with microinvasion: prognostic implications, long-term outcomes, and role of axillary evaluation. Int J Radiat Oncol Biol Phys, 82, 7-13. https://doi.org/10.1016/j.ijrobp.2010.08.027
  28. Park HS, Park S, Cho J, et al (2013). Risk predictors of underestimation and the need for sentinel node biopsy in patients diagnosed with ductal carcinoma in situ by preoperative needle biopsy. J Surg Oncol, 107, 388-92. https://doi.org/10.1002/jso.23273
  29. Parkin D M, Bray F, Ferlay J, Pisani (2005). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
  30. Patani N, Khaled Y, Al Reefy S, Mokbel K (2011). Ductal carcinoma in situ: An update for clinical practice. Surg Oncol, 20, 23-31. https://doi.org/10.1016/j.suronc.2010.08.007
  31. Pimiento JM, Lee MC, Esposito NN, et al (2011). Role of axillary staging in women diagnosed with ductal carcinoma in situ with microinvasion. J Oncol Pract, 7, 309-13. https://doi.org/10.1200/JOP.2010.000096
  32. Sacchini V, Fortunato L, Cody Iii HS, et al (2012). Breast ductal carcinoma in situ. Int J Surg Oncol, 2012, 753267.
  33. Schmale I, Liu S, Rayhanabad J, Russell CA, Sener SF (2012). Ductal carcinoma in situ (DCIS) of the breast: perspectives on biology and controversies in current management. J Surg Oncol, 105, 212-20. https://doi.org/10.1002/jso.22020
  34. Schneider C, Trocha S, Mckinley B, et al (2010). The use of sentinel lymph node biopsy in ductal carcinoma in situ. Am Surg, 76, 943-6.
  35. Scripcaru G, Zardawi IM (2012). Mammary ductal carcinoma in situ: a fresh look at architectural patterns. Int J Surg Oncol, 2012, 979521.
  36. Shibuya K, Mathers CD, Boschi-Pinto C, Lopez AD, Murray CJ (2002). Global and regional estimates of cancer mortality and incidence by site: Ii. Results for the global burden of disease 2000. BMC Cancer, 2, 37. https://doi.org/10.1186/1471-2407-2-37
  37. Shulman LN, Willett W, Sievers A, Knaul FM (2010). Breast cancer in developing countries: O ortunities for improved survival. J Oncol, 2010, 595167.
  38. Siziopikou KP (2013) Ductal carcinoma in situ of the breast: Current concepts and future directions. Arch Pathol Lab Med, 137, 462-6. https://doi.org/10.5858/arpa.2012-0078-RA
  39. Sorum R, Hofvind S, Skaane, Haldorsen T (2010). Trends in incidence of ductal carcinoma in situ: the effect of a population-based screening programme. Breast, 19, 499-505. https://doi.org/10.1016/j.breast.2010.05.014
  40. Tan KB, Lee HY, Putti TC (2002a). Ductal carcinoma in situ of the breast in singapore: recent trends and clinical implications. ANZ J Surg, 72, 793-7. https://doi.org/10.1046/j.1445-2197.2002.02550.x
  41. Tan H, Chuah KL, Chiang G, et al (2002b). Correlation of p53 and cerbb2 expression and hormonal receptor status with clinicopathologic parameters in ductal carcinoma in situ of the breast. Oncol Rep, 9, 1081-6.
  42. Tan H, Ho JT, Ng EH, et al (2000). Pathologic-radiologic correlations in screen-detected ductal carcinoma in situ of the breast: findings of the Singapore breast screening project. Int J Cancer, 90, 231-6. https://doi.org/10.1002/1097-0215(20000820)90:4<231::AID-IJC6>3.0.CO;2-U
  43. Tfayli A, Temraz S, Abou Mrad R, Shamseddine A (2010). Breast cancer in low- and middle-income countries: an emerging and challenging epidemic. J Oncol, 2010, 490631.
  44. Tuncbilek I, Ozdemir A, Gultekin S, et al (2007). Clinical outcome assessment in mammography: an audit of 7,506 screening and diagnostic mammography examinations. Diagn Interv Radiol, 13, 183-7.
  45. Usmani S, Khan HA, Al Saleh N, et al (2011). Selective a roach to radionuclide-guided sentinel lymph node biopsy in high-risk ductal carcinoma in situ of the breast. Nucl Med Commun, 32, 1084-7. https://doi.org/10.1097/MNM.0b013e328349eafc
  46. Wang LC, Sullivan M, Du H, Feldman MI, Mendelson EB (2013). Us a earance of ductal carcinoma in situ. Radiographics, 33, 213-28. https://doi.org/10.1148/rg.331125092
  47. Wang SC (2003). The singapore national breast screening programme: principles and implementation. Ann Acad Med Singapore, 32, 466-76.
  48. Wu GH, Chen LS, Chang KJ, et al (2006) Evolution of breast cancer screening in countries with intermediate and increasing incidence of breast cancer. J Med Screen, 13, 23-7.
  49. Yau TK, Chan K, Chant M, et al (2006). Wide local excision and radiotherapy for the treatment of ductal carcinoma in situ of the breast: The hong kong experience. Clin Oncol, 18, 447-52. https://doi.org/10.1016/j.clon.2006.04.003
  50. Yeoh KG, Chew L, Wang SC (2006). Cancer screening in singapore, with particular reference to breast, cervical and colorectal cancer screening. J Med Screen, 13, 14-9. https://doi.org/10.1258/096914106776179764
  51. Zhang W, Gao EL, Zhou YL, et al (2012). Different distribution of breast ductal carcinoma in situ, ductal carcinoma in situ with microinvasion, and invasion breast cancer. World J Surg Oncol, 10, 262. https://doi.org/10.1186/1477-7819-10-262

Cited by

  1. Evaluation of Factors Impacting Cosmetic Outcome of Breast Conservative Surgery - a Study in Iran vol.16, pp.6, 2015, https://doi.org/10.7314/APJCP.2015.16.6.2203