Dados do Trabalho

Título

CARCINOMA DUCTAL IN SITU: ANALISE CLINICA, IMAGINOLOGICA E TERAPEUTICA DE 332 PACIENTES DE UM CENTRO DE TRATAMENTO

Título em Inglês

CLINICAL, IMAGING AND THERAPEUTIC CHARACTERISTICS OF 332 PATIENTS WITH DUCTAL CARCINOMA IN SITU (DCIS): A SINGLE CENTER ANALYSIS

Introdução

Organized mammographic screening led to an increase in the diagnosis of DCIS. In countries with adequate mammographic coverage, the percentage of DCIS reaches 20%. In Brazil most of states only perform opportunistic mammographic screening and data about DCIS incidence is scarce.

Objetivos

Analyze and describe clinical, diagnostic, imaging and therapeutic characteristics of patients diagnosed with DCIS treated at Pérola Byington Hospital (PBH), Brazil.

Métodos

The official database of PBH from January 2011 to December 2019 is composed of 11,373 cases of breast cancer, 812 (7.4%) of DCIS. We analyzed retrospectively the medical record of 332 patients who underwent biopsy, vaccum assisted biopsy guided by mammography or ultrasound whose diagnosis was DCIS and were treated in the hospital. Patients with previous breast cancer or lobular neoplasia were excluded. We divided the analysis in two groups, based in the type of surgery they underwent, conservative or radical surgery. Some patients have been submitted to the sentinel lymph node biopsy (SNB) at surgery and blue technique stained by H&E was used.

Resultados

Most patients underwent conservative surgical treatment (73.5%), with a SNB in 34.5%. Mastectomy was performed in 26.5% of cases and in this group 93.2% there was also axillary surgery. None of the sentinel nodes was involved. In the conservative surgery group, the mammographic alterations were the main cause for the diagnosis in 80.3% of the times, with calcifications being the most common alteration in 73.9% of the cases, followed by the palpable lesion in 18.5%. Mammography was also the main diagnostic test in the group of patients who underwent mastectomy 73.9% of the time and calcifications appeared in 67% of cases, followed by palpable lesions in 28.1%. When assessing local recurrence, a percentage of 6,4% was found in conservative surgery (10 in situ and 5 invasive) and 4.5% in mastectomy (1 in situ and 4 invasive).

Conclusões

The 7.4% incidence of DCIS shows that even though lower than in countries that have organized screening, it is a growing demand, especially for the public health system were stereotactic biopsy in not available in many centers. Despite of most of the cases were non palpable we found that mastectomy was indicated in 23.5% probably because of the extension and multicentricity of the DCIS. The absence of metastases in SNB made us rethink the real need for its indication.

Palavras Chave

carcinoma ducal in situ of the breast , cdis , surgical treatment of cdis, axillary surgery and cdis, diagnostic of dcis of the breast

Área

TREATMENT - DCIS