Demographic, Clinical and Radiological Factors in Ductal Carcinoma In Situ of the Breast in Different Ethnic Groups: An Analysis of 75 Cases
RT Stapp, A Raghunathan, A Stark, DA Chitale. Henry Ford Health System, Detroit, MI
Background: Demographic data associated with invasive ductal carcinoma (IDC) have been extensively studied; however, data is relatively limited for ductal carcinoma in situ (DCIS). DCIS accounts for approximately 25% of all newly diagnosed breast cancers in women and due to extensive mammographic screening, its incidence has risen. The purpose of this study was to examine demographic, clinical and variables in DCIS that may predict risks of recurrence and outcome in different ethnic groups.
Design: We carried out a retrospective study of 75 cases of DCIS diagnosed in 1998-1999 and collected clinical data for 36 months or more of subsequent follow-up. The age at diagnosis, race, clinical and radiological presentation, DCIS grade & recurrence were recorded.
Results: African American (AA) patients comprised 25/75 (33%) of the cases, with 61 yrs average age at diagnosis. Average age of non-AA cases was 55 yrs. at diagnosis, being were significantly younger [t- test, p = 0.012]. DCIS was detected as a cluster of micro-calcifications on screening mammography in 17/24 (71%) AA cases compared to 40/50 (80%) in non-AA. In contrast, radiological masses were more frequently detected among AA cases 7/24 (29%) as compared to non-AA cases 10/50 (20%) [p=0.276, NS]. The pathologic specimens were graded as low (LG)-, intermediate (IG)-, and high-grade (HG) DCIS. Among the AA cases, 9/25 (36%) were LG, 7/25 (28%) IG, and 9/25 (36%) were HG DCIS. Among non-AA cases, 14/50 (28%) were LG, 14/50 (28%) IG and 22/50 (44%) HG DCIS [p=0.341, NS]. Recurrence was detected in 7/75 (9%) within 27 to 104 months of the therapeutic procedure. Both the recurrences among AA cases were HG DCIS (100%), while only 1/5 of the recurrences among non-AA was HG (20%). The cases had been followed for an average of 109 months from the time of diagnosis (46 to 131 months).
Conclusions: Our data suggests that DCIS occurred at an older age among AA cases. There is a trend towards a higher grade of recurrence among the AA cases. However, there is no statistically significant difference in the radiographic and pathologic features of DCIS between AA and non-AA cases. Further exploration of factors responsible for these trends within a larger cohort would help guide the optimal management of women who are at an increased risk of recurrence.
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 36, Tuesday Morning