Accuracy of mammography in predicting histological extent of ductal carcinoma in situ (DCIS)

Chakrabarti, J.; Evans, A.J.; James, J.; Ellis, I.O.; Pinder, S.E.; Macmillan, R.D.

doi:10.1016/j.ejso.2006.05.014

« Previous Next »European Journal of Surgical Oncology
Volume 32, Issue 10 , Pages 1089-1092, December 2006

Accuracy of mammography in predicting histological extent of ductal carcinoma in situ (DCIS)

J. Chakrabarti
- Department of Breast Surgery, Nottingham Breast Institute, Nottingham City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK
- Corresponding author. Tel.: +44 115 969 1169x39413; fax: +44 115 840 2618.
A.J. Evans
- Department of Breast Radiology, Nottingham Breast Institute, Nottingham City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK
J. James
- Department of Breast Radiology, Nottingham Breast Institute, Nottingham City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK
I.O. Ellis
- Department of Breast Pathology, Nottingham Breast Institute, Nottingham City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK
S.E. Pinder
- Department of Breast Pathology, Addenbrokes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ, UK
R.D. Macmillan
- Department of Breast Surgery, Nottingham Breast Institute, Nottingham City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK

Accepted 26 May 2006.

Abstract

Accuracy of mammography in predicting pathological extent of ductal carcinoma in situ (DCIS).

Background and aims

Mammographic extent is the main determinant for offering wide local excision (WLE) for DCIS. It is recognized that this is not always accurate. Patients who prove to have larger lesions than predicted require further surgery. The aim of this study was to define the degree of variance between mammographic (MMG) and pathological (path) measurements of DCIS and to analyse the factors predicting a significant discrepancy.

Methods

The pathological and mammographic data for 174 cases of DCIS were reviewed.

Results

The mammographic size was bigger than the histological size in 97 (55.7%) and there was >10mm difference in 18 (10.3%) cases. The histological size was bigger than the mammographic size in 69 (39.7%) cases and >10mm difference was found in 30 (17.2%) cases.

There was a significant relationship between larger MMG size, MMG size measured in two dimensions (MMG bi-dimensional product) and MMG–path size discrepancy (p<0.01). In addition, the larger the size discrepancy, the greater the chance of requiring more than one therapeutic procedure (p<0.01). There was no significant correlation between age, histological grade, mammographic density and shortest distance from nipple with degree of mammographic–pathological size discrepancy.

Keywords: Ductal carcinoma in situ, Mammographic–pathological correlation, Wide local excision