TY - JOUR
T1 - Microinvasive breast carcinoma
T2 - Clinicopathologic analysis of a single institution experience
AU - Padmore, Ruth F.
AU - Fowble, Barbara
AU - Hoffman, John
AU - Rosser, Cindy
AU - Hanlon, Alexandra
AU - Patchefsky, Arthur S.
N1 - Copyright 2000 American Cancer Society.
PY - 2000/3/15
Y1 - 2000/3/15
N2 - BACKGROUND. Microinvasive breast carcinoma (MIC) has a good prognosis but specific definitions have varied in the past, making the clinical significance of MIC a subject of debate. METHODS. Microscopic slides of 59 cases of breast carcinoma originally diagnosed as MIC were reviewed retrospectively. Histologic parameters were correlated with clinical findings and outcome to define diagnostic criteria better. RESULTS. On review, the 59 cases were recategorized as follows: pure DCIS (N = 16), DCIS with loci equivocal for microinvasion (N = 7), DCIS with ≥ 1 focus of microinvasion (N = 11), T1 invasive carcinomas with ≥ 90% DCIS (N = 18), and T1 tumors with < 90% DCIS (N = 7). The MIC cases in the current study averaged 3 separate loci of early infiltration outside the basement membrane, each one not > 1.0 mm. The mean follow-up was 95 months. Six patients (10%) had only local recurrence: 1 case each in patients with equivocal microinvasion, microinvasion, and T1 tumors with < 90% DCIS and 3 cases among the patients with T1 tumors with ≥ 90% DCIS. Four patients, all with T1 tumors with ≥ 90% DCIS, had distant failure (7%). In the MIC group, only one patient developed a local recurrence after breast conservation. No patient had axillary lymph node metastasis. For the entire series, factors associated with local recurrence were younger age, breast conservation versus mastectomy, and close surgical margins. The only factor associated with distant failure was the size of the DCIS component. Seven patients with T1 tumors with ≥90% DCIS experienced local or distant failure and 5 of these (71%) developed progressive disease or died of disease. All other patients who developed a recurrence were disease free at last follow-up. In a retrospective series, poorer outcome in carcinomas with ≥ 90% DCIS may be related to the greater likelihood of missed larger areas of invasive carcinoma. Therefore, meticulous and extensive sampling of these carcinomas is required. CONCLUSIONS. MIC as defined has a good prognosis. It has a different biology than T1 invasive carcinoma with ≥ 90% DCIS, which may progress and cause death. Large tumors with multiple loci of microinvasion may have metastatic potential. (C) 2000 American Cancer Society.
AB - BACKGROUND. Microinvasive breast carcinoma (MIC) has a good prognosis but specific definitions have varied in the past, making the clinical significance of MIC a subject of debate. METHODS. Microscopic slides of 59 cases of breast carcinoma originally diagnosed as MIC were reviewed retrospectively. Histologic parameters were correlated with clinical findings and outcome to define diagnostic criteria better. RESULTS. On review, the 59 cases were recategorized as follows: pure DCIS (N = 16), DCIS with loci equivocal for microinvasion (N = 7), DCIS with ≥ 1 focus of microinvasion (N = 11), T1 invasive carcinomas with ≥ 90% DCIS (N = 18), and T1 tumors with < 90% DCIS (N = 7). The MIC cases in the current study averaged 3 separate loci of early infiltration outside the basement membrane, each one not > 1.0 mm. The mean follow-up was 95 months. Six patients (10%) had only local recurrence: 1 case each in patients with equivocal microinvasion, microinvasion, and T1 tumors with < 90% DCIS and 3 cases among the patients with T1 tumors with ≥ 90% DCIS. Four patients, all with T1 tumors with ≥ 90% DCIS, had distant failure (7%). In the MIC group, only one patient developed a local recurrence after breast conservation. No patient had axillary lymph node metastasis. For the entire series, factors associated with local recurrence were younger age, breast conservation versus mastectomy, and close surgical margins. The only factor associated with distant failure was the size of the DCIS component. Seven patients with T1 tumors with ≥90% DCIS experienced local or distant failure and 5 of these (71%) developed progressive disease or died of disease. All other patients who developed a recurrence were disease free at last follow-up. In a retrospective series, poorer outcome in carcinomas with ≥ 90% DCIS may be related to the greater likelihood of missed larger areas of invasive carcinoma. Therefore, meticulous and extensive sampling of these carcinomas is required. CONCLUSIONS. MIC as defined has a good prognosis. It has a different biology than T1 invasive carcinoma with ≥ 90% DCIS, which may progress and cause death. Large tumors with multiple loci of microinvasion may have metastatic potential. (C) 2000 American Cancer Society.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Basement Membrane/pathology
KW - Breast Neoplasms/pathology
KW - Carcinoma in Situ/pathology
KW - Carcinoma, Ductal, Breast/pathology
KW - Disease Progression
KW - Disease-Free Survival
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Lymph Node Excision
KW - Mastectomy
KW - Mastectomy, Segmental
KW - Middle Aged
KW - Neoplasm Invasiveness
KW - Neoplasm Recurrence, Local/pathology
KW - Prognosis
KW - Retrospective Studies
KW - Survival Rate
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=0034653946&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000085921400018&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1002/(SICI)1097-0142(20000315)88:6<1403::AID-CNCR18>3.0.CO;2-S
DO - 10.1002/(SICI)1097-0142(20000315)88:6<1403::AID-CNCR18>3.0.CO;2-S
M3 - Article
C2 - 10717623
SN - 0008-543X
VL - 88
SP - 1403
EP - 1409
JO - Cancer
JF - Cancer
IS - 6
ER -