Mammographic features of local recurrence in women who have undergone breast-conserving therapy for ductal carcinoma in situ Journal Article


Authors: Liberman, L.; Van Zee, K. J.; Dershaw, D. D.; Morris, E. A.; Abramson, A. F.; Samli, B.
Article Title: Mammographic features of local recurrence in women who have undergone breast-conserving therapy for ductal carcinoma in situ
Abstract: OBJECTIVE. This study was undertaken to evaluate the mammographic features of local recurrence in women who have undergone breast-conserving therapy for ductal carcinoma in situ (DCIS). MATERIALS AND METHODS. Retrospective review revealed 162 women with DCIS treated with breast- conserving therapy from 1978 to 1990 for whom follow-up data were available. Subsequent to therapy, 33 (20%) patients had a pathologically proven carcinoma in the treated breast. Mammograms at the time of local recurrence were available for 20 patients. We reviewed mammograms, clinical charts, and histopathologic finding in these 20 patients. For 14 of 20 patients, we also reviewed mammograms obtained at the time of the original DCIS. RESULTS. The median interval from diagnosis of the original DCIS to local recurrence was 26 months (range, 6-168 months). Recurrences were detected solely by mammography in 17 (85%) of 20 patients, by mammography and physical examination in two (10%), and solely by physical examination in one (5%). Eighteen (90%) local recurrences contained calcifications and eighteen (90%) involved the tumorectomy quadrant. When we compared available mammographic findings of the original DCIS and the local recurrence, we found the mammographic pattern and calcification morphology to be the same in 11 (79%) of 14 DCIS and nine (82%) of 11 DCIS, respectively. Histopathologic analysis of recurrences found DCIS in 13 (65%) of 20 patients and DCIS and infiltrating carcinoma in the remaining seven (35%) patients. Of 13 pure DCIS recurrences, 12 (92%) were detected solely by mammography. CONCLUSION. In our study, local recurrence after breast-conserving therapy for DCI invariably contained DCIS: 35% of recurrences also contained invasive carcinoma. The most common mammographic pattern of local recurrence was calcifications in the tumorectomy quadrant that were morphologically similar to the original DCIS. These findings suggest that many of these local recurrences reflect failure to eradicate the primary DCIS. Mammography achieved high sensitivity in revealing these lesions: 85% of local recurrences and 92% of recurrences that were pure DCIS were detected solely by mammography.
Keywords: adult; clinical article; human tissue; aged; middle aged; retrospective studies; histopathology; cancer recurrence; radiotherapy, adjuvant; follow-up studies; cancer diagnosis; sensitivity and specificity; neoplasm recurrence, local; breast neoplasms; retrospective study; time factors; mammography; carcinoma in situ; partial mastectomy; intraductal carcinoma; mastectomy, segmental; carcinoma, ductal, breast; humans; human; female; priority journal; article
Journal Title: American Journal of Roentgenology
Volume: 168
Issue: 2
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 1997-02-01
Start Page: 489
End Page: 493
Language: English
PUBMED: 9016233
PROVIDER: scopus
DOI: 10.2214/ajr.168.2.9016233
DOI/URL:
Notes: Article -- Presented at the Annual Meeting of the American Roentgen Ray Society, that took place in May 1996 in San Diego, CA -- Export Date: 17 March 2017 -- Source: Scopus
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MSK Authors
  1. D David Dershaw
    223 Dershaw
  2. Laura Liberman
    176 Liberman
  3. Kimberly J Van Zee
    293 Van Zee
  4. Elizabeth A Morris
    336 Morris