Summary
Ductal carcinoma in situ (DCIS) is mostly diagnosed by mammography. The incidence is between 1% and 5% in countries without widespread use of mammography, but the incidence in mammography screening programs is between 8% and 25%. However, DCIS can also be diagnosed by galactography in patients with nipple discharge, by ultrasound, and sometimes also by MRI. These methods can tell precisely how big the cancer is and exactly where in the breast. However, to morphologically verify a suspicion of malignancy from any of these imaging methods, needle biopsy can be performed. By using needle biopsy, surgery can be planned more accurately as a curative measure instead of as a diagnostic biopsy. Fine-needle biopsy with thin needles for cytological diagnosis can be used successfully, especially in DCIS of the comedo type, but this technique is more operator dependent than core-needle biopsy and vacuum-assisted biopsy techniques where small pieces of tissue are sampled for histopathological analyses and diagnosis. There are no real complications for all these techniques. Patients diagnosed with DCIS have an excellent prognosis to survive without any local recurrences and general metastases.
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References
Bray F, Sankila R, Ferlay J, et al (2002) Estimates of cancer incidence and mortality in Europe in 1995. Eur J Cancer 39:99
Claus EB, Stowe M, Carter D (2003) Family history of breast and ovarian cancer and the risk of breast cancer in situ. Cancer Res Treat 78(1):7–15
Tabár L, Dean P, Kaufman CS, et al (2000) A new era in the diagnosis of breast cancer. Surg Oncol Clin N Am 9(2):233
Mokbel K (2003) Towards optimal management of DCIS of the breast. Eur J Surg Oncol 29(2):191–197
Dinkel HP, Gassel AM, Muller T, et al (2001) Galactography and exfoliative cytology in women with abnormal nipple discharge. Obstct Gynecol 784:625–629
Hou MF, Huang TJ, Liu GC (2001) The diagnostic value of galactography in patients with nipple discharge. Clin Imaging 25(2):75–81
Okazaki A, Hirata K, Okazaki M, et al (1999) Nipple discharge disorders: current management and the role of fiber-ductoscopy. Eur Radiol 9:583–590
Martin HE, Ellis EB (1930) Biopsy by needle puncture and aspiration. Ann Surg 92: 169–181
Nordenström B, Rydén H, Svane G (1981) Breast. In: Zornoza J (ed) Percutaneous needle biopsy. Williams & Wilkins, Baltimore, p 43
Svane G, Silfverswärd C (1983) Stereotaxic needle biopsy of non-palpable breast lesions. Cytologic and histopathologic findings. Acta Radiol Diagn 24(4):283
Elvin A, Andersson T, Jaremko G, et al (1994) Significance of operator experience in diagnostic accuracy of biopsy gun biopsies. Eur Radiol 4:430
Lifrange E, Kridelka F, Colin C (1997) Stereotaxic needle core biopsy and fine needle aspiration biopsy in the diagnosis of non-palpable breast lesions: controversies and future prospects. Eur J Radiol 24:39
Leifland K, Lundquist H, Lagerstedt U, et al (2003) Comparison of preoperative simultaneous fine needle aspiration biopsy and core needle biopsy in ductal carcinoma in situ of the breast. Acta Radiol Diagn 44:213–217
Liberman L, la Trenta LR, Van Zee KJ, et al (1997) Stereotaxic core biopsy of calcifications highly suggestive of malignancy. Radiology 203:673
Cangiarella J, Waisman J, Symmers WF, et al (2001) Mammotome core biopsy for mammary microcalcification: analysis of 160 biopsies from 142 women with surgical and radiological follow up. Cancer (Phila) 119(1):173
Adrales G, Turk P, Wallace T, et al (2000) Is surgical excision necessary for atypical ductal hyperplasia of the breast diagnosed by Mammotome? Am J Surg 180(4):313
Joshi M, Duva-Frissora A, Padmanabhan R, et al (2001) Atypical ductal hyperplasia in stereotactic breast biopsies: enhanced accuracy of diagnosis with the mammotome. Breast J 7(4):207
Renshaw AA (2002) Predicting invasion in the excision specimen from breast core needle biopsy specimens with only ductal carcinoma in situ. Arch Pathol Lab Med 126(1):39–41
King TA, Farr GH Jr, Cederbom GJ, et al (2001) A mass on breast imaging predicts coexisting invasive carcinoma in patients with a core biopsy diagnosis of ductal carcinoma in situ. Am Surg 67(9):907–912
Wahedna Y (2001) Mammographic size of ductal carcinoma in situ does not predict the presence of an invasive focus. Eur J Cancer 37(4):459–462
Diaz LK, Wiley EL, Venta LA (1989) Are malignant cells displaced by large-gauge needle core biopsy of the breast? AJR (Am J Roentgenol) 173(5):1303–1313
Stolier A, Skinner J, Levine EA (2000) A prospective study of seeding of the skin after core biopsy of the breast. Am J Surg 180(2):104–107
Davies JD, Nonni A, D’Costa HF (1997) Mammary epidermoid inclusion cysts after wide-core needle biopsies. Histopathology (Oxf) 31(6):549–551
Speigel AJ, Butler CE (2003) Recurrence following treatment of DCIS with skin-sparing mastectomy and immediate breast reconstruction. Plast Reconstr Surg 111(2):706–711
Aref A, Youssef E, Washington T, et al (2000) The value of postlumpectomy mammogram in the management of breast cancer patients presenting with suspicious microcalcifications. Cancer J Sci Am 6(1):11–12
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© 2005 Springer-Verlag Tokyo
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Svane, G. (2005). Ductal Carcinoma In Situ (DCIS): Incidence, Prognosis, and Diagnostic Aspects of Mammography, Galactography, and Needle Biopsies. In: Ueno, E., Shiina, T., Kubota, M., Sawai, K. (eds) Research and Development in Breast Ultrasound. Springer, Tokyo. https://doi.org/10.1007/4-431-27008-6_16
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DOI: https://doi.org/10.1007/4-431-27008-6_16
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