Implications of diagnosing ductal carcinoma in situ in core needle biopsies of the breast

Objective:

To study the implications of Ductal Carcinoma In Situ (DCIS) diagnosis in Core Needle Biopsies (CNBs) of the breast.

Method:

The histology slides of 59 CNBs and BCS (Breast conserving surgery) /Mastectomy were reviewed for the presence and percentage of DCIS and 63 BCS were reviewed for positivity of the surgical margins. SPSS -13 and appropriate statistical tests were used for analysis.

Results:

The sensitivity of CNB to predict DCIS in the surgical specimen was 45.65%. A positive relationship was established between DCIS positivity in CNB and DCIS percentage in the subsequent surgical specimen (p=0.002). A positive correlation exists between the number of positive margins and percentage of DCIS (p<0.01) in BCS specimens. The difference in the number of cores obtained was significant among the true DCIS positive and false negative cases (p=0.006).

Conclusion:

DCIS in CNB is often associated with DCIS in BCS/mastectomy in a higher percentage of the same. A higher percentage of DCIS frequently has positive BCS margins, thus wider excisions are indicated for women with DCIS positive CNB's. Sensitivity of identifying DCIS in the CNB increases with number of CNB cores.

DOI: http://dx.doi.org/10.4038/jdp.v6i1.4419

Journal of Diagnostic Pathology 2011(6); 1: 28-33