Relationship between the size and margin status of ductal carcinoma in situ of the breast and residual disease

Liang Cheng, Nadia K. Al-Kaisi, Nahida H. Gordon, Alison Y. Liu, Fadi Gebrail, Robert R. Shenk

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Abstract

Background: For women with ductal carcinoma in situ (DCIS) of the breast who have been treated with breast-conserving surgery, the usefulness of size and surgical margin status (i.e., presence or absence of disease at the point of excision) as prognostic factors for predicting residual disease has not been well established. This study was conducted to determine more clearly the relationship between size and margin status of mammary DCIS to residual disease. Methods: The pathology records of 232 consecutive patients with mammary DCIS who had been initially treated with lumpectomy at the University Hospitals of Cleveland were retrospectively reviewed. The size of the DCIS and the surgical margins of lumpectomy were analyzed. Residual disease was defined as the persistence of DCIS in the re-excision and/or mastectomy specimens. Results: Residual disease was found in 15 of 101 patients with DCIS of less than 1.0 cm in longest dimension, in 27 of 96 patients with DCIS of 1.0-2.4 cm in size, and in 24 of 35 patients with DCIS of greater than or equal to 2.5 cm in size (P1 mm) (P = .001). In multivariate analysis, the occurrence of residual disease was associated with large tumor size (i.e., ≤2.5 cm) (odds ratio [OR] = 7.7; 95% confidence interval [CI] = 3.13-20.00; two-sided P = .0001) and with positive margin status (OR = 2.2; 95% CI = 1.02-4.55; two- sided P = .04). Conclusions: The size and margin status of DCIS each were found to be independent predictors of residual disease.

Original languageEnglish (US)
Pages (from-to)1356-1360
Number of pages5
JournalJournal of the National Cancer Institute
Volume89
Issue number18
StatePublished - Sep 17 1997
Externally publishedYes

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Breast Diseases
Carcinoma, Intraductal, Noninfiltrating
Segmental Mastectomy
Carcinoma, Ductal, Breast
Odds Ratio
Confidence Intervals
Mastectomy
Breast
Multivariate Analysis
Pathology

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Relationship between the size and margin status of ductal carcinoma in situ of the breast and residual disease. / Cheng, Liang; Al-Kaisi, Nadia K.; Gordon, Nahida H.; Liu, Alison Y.; Gebrail, Fadi; Shenk, Robert R.

In: Journal of the National Cancer Institute, Vol. 89, No. 18, 17.09.1997, p. 1356-1360.

Research output: Contribution to journalArticle

Cheng, Liang ; Al-Kaisi, Nadia K. ; Gordon, Nahida H. ; Liu, Alison Y. ; Gebrail, Fadi ; Shenk, Robert R. / Relationship between the size and margin status of ductal carcinoma in situ of the breast and residual disease. In: Journal of the National Cancer Institute. 1997 ; Vol. 89, No. 18. pp. 1356-1360.
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abstract = "Background: For women with ductal carcinoma in situ (DCIS) of the breast who have been treated with breast-conserving surgery, the usefulness of size and surgical margin status (i.e., presence or absence of disease at the point of excision) as prognostic factors for predicting residual disease has not been well established. This study was conducted to determine more clearly the relationship between size and margin status of mammary DCIS to residual disease. Methods: The pathology records of 232 consecutive patients with mammary DCIS who had been initially treated with lumpectomy at the University Hospitals of Cleveland were retrospectively reviewed. The size of the DCIS and the surgical margins of lumpectomy were analyzed. Residual disease was defined as the persistence of DCIS in the re-excision and/or mastectomy specimens. Results: Residual disease was found in 15 of 101 patients with DCIS of less than 1.0 cm in longest dimension, in 27 of 96 patients with DCIS of 1.0-2.4 cm in size, and in 24 of 35 patients with DCIS of greater than or equal to 2.5 cm in size (P1 mm) (P = .001). In multivariate analysis, the occurrence of residual disease was associated with large tumor size (i.e., ≤2.5 cm) (odds ratio [OR] = 7.7; 95{\%} confidence interval [CI] = 3.13-20.00; two-sided P = .0001) and with positive margin status (OR = 2.2; 95{\%} CI = 1.02-4.55; two- sided P = .04). Conclusions: The size and margin status of DCIS each were found to be independent predictors of residual disease.",
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AU - Al-Kaisi, Nadia K.

AU - Gordon, Nahida H.

AU - Liu, Alison Y.

AU - Gebrail, Fadi

AU - Shenk, Robert R.

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N2 - Background: For women with ductal carcinoma in situ (DCIS) of the breast who have been treated with breast-conserving surgery, the usefulness of size and surgical margin status (i.e., presence or absence of disease at the point of excision) as prognostic factors for predicting residual disease has not been well established. This study was conducted to determine more clearly the relationship between size and margin status of mammary DCIS to residual disease. Methods: The pathology records of 232 consecutive patients with mammary DCIS who had been initially treated with lumpectomy at the University Hospitals of Cleveland were retrospectively reviewed. The size of the DCIS and the surgical margins of lumpectomy were analyzed. Residual disease was defined as the persistence of DCIS in the re-excision and/or mastectomy specimens. Results: Residual disease was found in 15 of 101 patients with DCIS of less than 1.0 cm in longest dimension, in 27 of 96 patients with DCIS of 1.0-2.4 cm in size, and in 24 of 35 patients with DCIS of greater than or equal to 2.5 cm in size (P1 mm) (P = .001). In multivariate analysis, the occurrence of residual disease was associated with large tumor size (i.e., ≤2.5 cm) (odds ratio [OR] = 7.7; 95% confidence interval [CI] = 3.13-20.00; two-sided P = .0001) and with positive margin status (OR = 2.2; 95% CI = 1.02-4.55; two- sided P = .04). Conclusions: The size and margin status of DCIS each were found to be independent predictors of residual disease.

AB - Background: For women with ductal carcinoma in situ (DCIS) of the breast who have been treated with breast-conserving surgery, the usefulness of size and surgical margin status (i.e., presence or absence of disease at the point of excision) as prognostic factors for predicting residual disease has not been well established. This study was conducted to determine more clearly the relationship between size and margin status of mammary DCIS to residual disease. Methods: The pathology records of 232 consecutive patients with mammary DCIS who had been initially treated with lumpectomy at the University Hospitals of Cleveland were retrospectively reviewed. The size of the DCIS and the surgical margins of lumpectomy were analyzed. Residual disease was defined as the persistence of DCIS in the re-excision and/or mastectomy specimens. Results: Residual disease was found in 15 of 101 patients with DCIS of less than 1.0 cm in longest dimension, in 27 of 96 patients with DCIS of 1.0-2.4 cm in size, and in 24 of 35 patients with DCIS of greater than or equal to 2.5 cm in size (P1 mm) (P = .001). In multivariate analysis, the occurrence of residual disease was associated with large tumor size (i.e., ≤2.5 cm) (odds ratio [OR] = 7.7; 95% confidence interval [CI] = 3.13-20.00; two-sided P = .0001) and with positive margin status (OR = 2.2; 95% CI = 1.02-4.55; two- sided P = .04). Conclusions: The size and margin status of DCIS each were found to be independent predictors of residual disease.

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