Clinicopathological characteristics, treatments, and prognosis of breast ductal carcinoma in situ with microinvasion: A narrative review

Q1 Medicine

Chronic Diseases and Translational Medicine Pub Date : 2022-11-26 DOI:10.1002/cdt3.53

Ge Song, Yongqiang Zhang

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引用次数: 2

Abstract

Background

Ductal carcinoma in situ with microinvasion (DCIS-MI) is defined as ductal carcinoma in situ (DCIS) with a microscopic invasive focus ≤1 mm in the longest diameter. The current literature is controversial concerning the clinical prognostic features and management of DCIS-MI. This narrative review described recently reported literature regarding the characteristics, treatment, and prognosis of it.

Methods

Searching PubMed for relevant articles covering the period of 1982 to 2021 using the following terms by MeSH and free-word: breast cancer, microinvasion, DCIS, DCIS-MI, and invasive ductal carcinoma (IDC).

Results

DCIS-MI tends to express more aggressive pathological features such as necrosis, HER2+, ER- or PR-, and high nuclear grade. The overall prognosis of DCIS-MI is typically good, however, some indicators such as young age, HR-, HER2+ and multimicroinvasive lesions, were associated with worse prognoses. And there are also conflicting results on the differences between the prognoses of DCIS-MI and DCIS or T1a-IDC. Postoperative chemotherapy and anti-HER2 therapy still have uncertain benefits and are more likely to be used to treat high-risk patients who are HR- orHER2+ to improve the prognosis.

Conclusion

DCIS-MI has more aggressive pathological features, which may suggest its biological behavior is worse than that of DCIS and similar to early IDC. Although the overall prognosis of DCIS-MI is good, when making decisions about adjuvant therapy clinicians need to give priority to the hormone receptor status, HER2 expression and axillary lymph node status of patients, because these may affect the prognosis and treatment response.

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乳腺导管原位癌伴微侵的临床病理特点、治疗及预后:综述

导管原位癌伴微浸润(Ductal carcinoma in situ with microinvasive，简称DCIS- mi)是指显微浸润病灶最长直径≤1mm的导管原位癌(Ductal carcinoma in situ，简称DCIS)。目前文献对DCIS-MI的临床预后特征和治疗存在争议。这篇叙述性综述描述了最近报道的关于其特征、治疗和预后的文献。方法使用MeSH和自由词检索PubMed中1982 - 2021年间的相关文章:乳腺癌、微侵袭、DCIS、DCIS- mi和浸润性导管癌(invasive ductal carcinoma, IDC)。结果DCIS-MI多表现为坏死、HER2+、ER-或PR-、高核分级等侵袭性病理特征。DCIS-MI的总体预后通常较好，但一些指标如年龄小、HR-、HER2+、多微创病变等与预后较差相关。关于DCIS- mi与DCIS或T1a-IDC预后差异的研究结果也存在矛盾。术后化疗和抗her2治疗的获益仍不确定，更有可能用于HR-或her2 +的高危患者，以改善预后。结论DCIS- mi具有更强侵袭性的病理特征，可能提示其生物学行为较DCIS差，与早期IDC相似。虽然DCIS-MI的整体预后良好，但在辅助治疗决策时，临床医生需要优先考虑患者的激素受体状态、HER2表达和腋窝淋巴结状态，因为这些可能影响预后和治疗反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chronic Diseases and Translational Medicine Medicine-General Medicine

CiteScore

6.70

自引率

0.00%

发文量

195

审稿时长

35 weeks

期刊介绍： This journal aims to promote progress from basic research to clinical practice and to provide a forum for communication among basic, translational, and clinical research practitioners and physicians from all relevant disciplines. Chronic diseases such as cardiovascular diseases, cancer, diabetes, stroke, chronic respiratory diseases (such as asthma and COPD), chronic kidney diseases, and related translational research. Topics of interest for Chronic Diseases and Translational Medicine include Research and commentary on models of chronic diseases with significant implications for disease diagnosis and treatment Investigative studies of human biology with an emphasis on disease Perspectives and reviews on research topics that discuss the implications of findings from the viewpoints of basic science and clinical practic.