Clinical Significance of Invasive Ductal Carcinoma with Predominant Intraductal Component in Breast Cancer -Comparison with T1 Invasive Ductal Carcinoma-

Journal of Korean Breast Cancer Society Pub Date : 2002-06-01 DOI:10.4048/JKBCS.2002.5.2.147

B. Son, K. Lee, C. Kim, H. Yoon, S. Ahn

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Abstract

Purpose: In the WHO classification of breast carcinoma, invasive ductal carcinoma with predominant intraductal component (IDC with PIC) has been defined as carcinomas in which the component of ductal carcinoma in situ amounts to four times more than the invasive element in area. This study was designed to evaluate the clinicopathological significance of IDC with PIC. Methods: Five hundred and seventy nine patients with breast cancer (154 IDC with PIC and 425 with T1 invasive ductal carcinomas) treated with mastectomy or breast conserving surgery between 1989 and 1998 at the Asan Medical Center were divided into two study groups (IDC with PIC and T1 IDC) and compared the clinicopathological characteristics and survival of both groups. Results: By comparison with the T1 IDC, the IDC with PIC has several distinct features including younger mean age of occurrence (45.3 years vs 48.3 years, P=0.002), larger mean tumor size (3.5 cm vs 1.6 cm, P<0.001), lower incidence of axillary lymph node metastasis (15.7% vs 31.3%, P< 0.001) and estrogen receptor positivity (45.7% vs 59.2%, P=0.03), higher incidence of low histologic grade (78.7% vs 61.7%, P=0.002) and cancer detection rate by screening without symptom (21.6% vs 11.5%, P=0.003) or clinical manifestation of nipple discharge (17.3% vs 4.3%, P<0.001) and microcalcification with or without mass on mammography (58.7% vs 30.2%, P<0.001). There were no significant difference in the cumulative 5-year overall and disease-free survival rates (93.1% vs 90.1%, P=0.78; 89.5% vs 86%, P=0.23). In the IDC with PIC group, tumors larger than 2 cm in size were more frequently metastasized to axillary lymph nodes than tumors smaller than 2 cm, but this finding was not significant (P=0.07). Conclusion: Invasive ductal carcinoma with predominant intraductal component showed less invasive and more low-grade malignant characteristics than T1 invasive ductal carcinoma. Survival was not statistically different. (Journal of Korean Breast Cancer Society 2002;5:147-153)

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以导管内成分为主的浸润性导管癌在乳腺癌中的临床意义与T1浸润性导管癌的比较

目的:WHO对乳腺癌的分类中，浸润性导管癌(invasive ductal carcinoma with dominant intrductal component, IDC with PIC)被定义为原位导管癌成分大于浸润性导管成分4倍的肿瘤。本研究旨在评估IDC合并PIC的临床病理意义。方法:将1989 ~ 1998年峨山医院行乳房切除术或保乳手术的579例乳腺癌患者(IDC合并PIC患者154例，T1期浸润性导管癌患者425例)分为IDC合并PIC组和T1期浸润性导管癌组，比较两组患者的临床病理特征和生存率。结果:与T1型IDC相比，PIC型IDC的平均发病年龄较低(45.3岁vs 48.3岁，P=0.002)，肿瘤平均体积较大(3.5 cm vs 1.6 cm, P<0.001)，腋窝淋巴结转移发生率较低(15.7% vs 31.3%， P<0.001)，雌激素受体阳性发生率较低(45.7% vs 59.2%， P=0.03)，低组织学分级发生率较高(78.7% vs 61.7%， P=0.002)，无症状筛查的癌症检出率较高(21.6% vs 11.5%)。P=0.003)或乳头溢液的临床表现(17.3% vs 4.3%， P<0.001)和乳房x光检查伴有或不伴有肿块的微钙化(58.7% vs 30.2%， P<0.001)。累积5年总生存率和无病生存率无显著差异(93.1% vs 90.1%， P=0.78;89.5% vs 86%， P=0.23)。在IDC合并PIC组中，大于2cm的肿瘤比小于2cm的肿瘤更容易转移到腋窝淋巴结，但这一发现无统计学意义(P=0.07)。结论:以导管内成分为主的浸润性导管癌较T1浸润性导管癌侵袭性小，恶性程度低。生存率无统计学差异。(韩国乳腺癌学会杂志2002;5:147-153)

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Journal of Korean Breast Cancer Society

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