Preoperatively diagnosed ductal cancers in situ of the breast presenting as even small masses are of high risk for the XXXX foci in postoperative specimen.

@entity513 @entity1 @entity3
BACKGROUND: In @entity513 in situ of the breast (DCIS), histologic diagnosis obtained before the definitive treatment is related to the risk of underestimation if the presence of @entity3 is found postoperatively. These @entity1 need a second operation to assess the nodal status. We evaluated the upstaging rate in @entity1 with mass-forming DCIS. METHODS: Sixty-three @entity1 with pure DCIS presenting as sonographic mass lesion underwent vacuum-assisted or core-needle biopsy and subsequent surgery. Rates of postoperative upstaging to @entity3 were calculated and compared with clinical character and size of DCIS. RESULTS: Median age of @entity1 (range) was 63  years (27-88) while median diameter of DCIS was 11  mm (6-60). Fifty-six percent of DCIS were upstaged. @entity1 age did not differ significantly between groups with and without final invasion (median, mean, SD): 63, 61.4, 12.5 vs 62, 61.2, 10.6  years, respectively (P   =   0.659). The difference of DCIS size between these groups was statistically important (median, mean, SD): 13, 17.3, 11.4 vs 9.5, 9.8, 3.2  mm, respectively (P   =   0.0003). Mass size and palpability were significant risk factors (P   <   0.001 and P   <   0.01, respectively). Rate of underestimation for mass with diameter  <=10  mm, 10-20  mm and >20  mm was 37, 64 and 91  %, respectively. CONCLUSIONS: DCIS diagnosed on minimal-invasive biopsy of even small sonographic mass is of high risk for the upstaging to @entity3 after final surgical excision. In these @entity1 , subsequent intervention is needed for nodal status assessment. They are good candidates for the sentinel node biopsy during the breast operation to avoid multi-step surgery.
