유관 상피내암(DCIS)에 대한 임상적, 병리학적 분석 및 생물학적 표지자들의 발현과 예후인자들과의 관계
Ductal Carcinoma In Situ (DCIS) of the Breast; Clinico-pathological Analysis, Expression of Molecular Markers, and Correlations between Known Prognostic Factors
강성수, 고승상, 조백현, 허민희, 이해경, 이성공, 전이경, 김의정, 이경상, 홍성란, 이지현,
소속 상세정보
강성수 ( Kang Sung-Soo )
성균관대학교 의과대학 삼성제일병원 외과
고승상 ( Ko Seung-Sang )
성균관대학교 의과대학 삼성제일병원 외과
조백현 ( Cho Back-Hyun )
성균관대학교 의과대학 삼성제일병원 외과
허민희 ( Hur Min-Hee )
성균관대학교 의과대학 삼성제일병원 외과
이해경 ( Lee Hae-Kyung )
성균관대학교 의과대학 삼성제일병원 외과
이성공 ( Lee Sung-Kong )
성균관대학교 의과대학 삼성제일병원 외과
전이경 ( Chun Yee-Kyung )
성균관대학교 의과대학 삼성제일병원 해부병리과
김의정 ( Kim Yee-Jeong )
성균관대학교 의과대학 삼성제일병원 해부병리과
이경상 ( Lee Kyung-Sang )
성균관대학교 의과대학 삼성제일병원 진단방사선과
홍성란 ( Hong Sung-Ran )
성균관대학교 의과대학 삼성제일병원 해부병리과
이지현 ( Lee Jee-Hyun )
성균관대학교 의과대학 삼성제일병원 외과
KMID : 0371320030640040289
Abstract
PURPOSE: The improved availability of breast cancer screening, including mammography, has dramatically increased the detection rate of DCIS (ductal carcinoma in situ). However, there has been controversy regarding the clinico-pathological
characteristics and optimal management of DCIS. This analysis was conducted in order to evaluate the clinico-pathological findings of DCIS, and any possible correlations between the known prognostic factors.
METHODS: We analyzed 58 consecutive cases of DCIS, from 1990 to 1995, including data on the annual proportion of DCIS to total breast cancer cases, the clinico-pathological characteristics and the expressions of ER, PR, c-erbB-2 and p53. The median length of follow-up was 98.5 months.
RESULTS: The proportion of DCIS was 8.8%, with progressive increases from 1990 to 1995. The mean age at diagnosis was 47.1 years, with the peak of prevalence seen in women aged 40~49 years. The most common presentation was a palpable breast mass in 28 (48.3%) cases, but 18 (31%) patients were asymptomatic. The mammographic findings demonstrated calcification in 75% and mass density in 59.6%. There was only 1 (1.8%) case of a bilateral lesion, and 5 (8.6%) of multifocal or multicentric lesions. Axillary lymph nodes were positive in 5.5% of the patients who underwent an axillary dissection. Breast conserving operations were performed in 8 (13.8%) cases. The frequencies of ER, PR, c-erbB-2 and p53, positivity, by immunohistochemistry were 52, 50, 55.1 and 30.6%, respectively. c-erbB-2 immunoreactivity was found more often in DCIS with larger size, higher nuclear grade and negative ER and PR (P=0.011, P=0.001, P=0.002, and P=0.006, respectively). There was a significant association between higher nuclear grade and negative ER and PR, and comedotype (P=0.001, P=0.000, and 0.008, respectively). Although an invasive ductal carcinoma had developed in 5.4% of the contralateral breasts, there were no cases of systemic relapse, or disease-specific mortality, at the last follow-up.
키워드
유방암;유관상피내암;생물학적 표지자
Breast cancer;Ductal carcinoma in situ (DCIS);Molecular markers
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