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January 1989

Nonpalpable In Situ Ductal Carcinoma of the BreastPredictors of Multicentricity and Microinvasion and Implications for Treatment

Author Affiliations

From the Departments of Surgery (Drs Schwartz, Sohn, and Singer), Pathology (Drs Patchefsky and Prestipino), and Radiology (Dr Feig), Jefferson Medical College; and the Department of Pathology, Hahnemann University (Dr Finklestein), Philadelphia. Dr Patchefsky is now with Hahnemann University, Philadelphia.

Arch Surg. 1989;124(1):29-32. doi:10.1001/archsurg.1989.01410010035007

• Fifty breasts with nonpalpable ductal carcinoma in situ (DCIS) were examined for the presence of microinvasion, multicentricity, and number of involved ducts to see if the biopsy specimen could have predicted the findings in the remainder of the breast. When DCIS was an incidental finding, fewer ducts were involved and no evidence of either microinvasion or multicentricity was found. Solid and cribriform DCIS were rarely multicentric or microinvasive; micropapillary DCIS was often multicentric, rarely microinvasive; comedocarcinoma was more likely to be both microinvasive and multicentric. Ductal carcinoma in situ as an incidental finding may be treated by excision alone; papillary and micropapillary DCIS are best treated by therapy aimed at the entire breast, although axillary dissection may not be required. Therapy for comedocarcinomas should include the entire breast and the axillary nodes.

(Arch Surg 1989;124:29-32)