Continued Observation of the Natural History of Low-Grade Ductal Carcinoma In Situ in Women Treated by Biopsy Only Reaffirms Proclivity for Local Recurrence in the Original Site over More Than 30 Years Long-Term Follow-Up
ME Sanders, PA Schuyler, JF Simpson, WD Dupont, DL Page. Vanderbilt University, Nashville, TN
Background: Opportunities to study the natural history of ductal carcinoma in situ (DCIS) are rare. A few studies of incompletely excised lesions in the premammographic era now recognized as DCIS have provided critical insights into its proclivity for local recurrence in the original site. At the time the biopsies in the current study were originally examined, small DCIS was not diagnosed and, by default, these women were treated by biopsy only.
Design: The authors report the latest results from a follow-up study, which was published originally in 1982, now of 45 women with DCIS who were treated by biopsy only. These women were from a large, prospectively identified, completely characterized cohort.
Results: Sixteen of 45 women developed invasive breast carcinoma (IBC), all in the same breast and quadrant from which their DCIS biopsy was taken. Twelve IBCs were diagnosed within 10 years of the DCIS biopsy, 1 was diagnosed within 12 years of the DCIS biopsy, and the remaining 3 IBCs were diagnosed over 23-42 years. Seven of these women, including 1 woman who developed IBC 29 years after her low grade DCIS biopsy, developed distant metastasis, which resulted in death 7 years after the diagnosis of IBC.
Conclusions: The natural history of low-grade DCIS can extend greater than 4 decades, with IBC developing at the same site as the previous DCIS in the majority of women. This natural history differs markedly from that of patients with high-grade DCIS and from the outcome of patients with any completely delimited DCIS excised to negative margins.
Monday, March 22, 2010 11:00 AM
Platform Session: Section C, Monday Morning