Our orientation regarding the ductal carcinoma in situ of the breast

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COD: 06_2012_497-502 Categorie: ,

Pasquale Petronella, Marco Scorzelli, Marco Ferretti, Giuseppe Perna, Fulvio Freda, Silvestro Canonico

Ann. Ital. Chir., 2012 83: 497-502

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AIM: The ductal carcinoma in situ is a malignant proliferation of mammary ductal epithelial cells without invasion beyond the basement membrane. The management of patients with DCIS is complex, controversial and has undergone changes over time. MATERIAL OF STUDY: We treated 65 patients diagnosed with DCIS between 2002 and 2005. We surveyed women aged between 28 and 71 years (average age 51.4), the DCIS in 16 patients appeared as a palpable mass (about 2.2 cm) group I and in 49 patients as microcalcifications detected on mammography – group II. RESULTS: The most frequent histological type was found to be the comedocarcinoma. After 3 years of follow-up, we had 3 cases of recurrence (4.6%) in patients undergoing conservative surgery, with Van Nuys Prognostic Index between 3 and 4. DISCUSSION: 15-25% of cases of breast cancer are DCIS. Most of these are comedocarcinomas. Comedo form DCIS is an insidious cancer. Surgical treatment ranges from mastectomy to excision of the lesion, often the latter, followed by radiotherapy. CONCLUSION: We prefer, with regard to surgical treatment, quadrantectomy with systematic control of the free margins. The search for the axillary sentinel node represents for us, too, the gold standard.