Predictors of invasive breast cancer and lymph node involvement in ductal carcinoma in situ initially diagnosed by vacuum-assisted breast biopsy: experience of 733 cases

Breast. 2012 Oct;21(5):635-40. doi: 10.1016/j.breast.2012.06.009. Epub 2012 Jul 12.


Objective: To predict presence of invasive component and nodal involvement in women diagnosed preoperatively with ductal carcinoma in situ (DCIS) by vacuum-assisted breast biopsy (VABB).

Materials and methods: We retrospectively analyzed 733 patients with preoperatively diagnosed DCIS, investigating the association of clinical-radiological variables with invasive component and nodal involvement.

Results: Mammographic size >20 mm and residual lesion on post-VABB mammogram were related to invasive component (both p < 0.0001) and nodal involvement (p = 0.001, p = 0.03). Age <40 years was associated with presence of invasive component (p = 0.003). By multivariate analysis residual disease was associated with invasive component, and mammographic tumor size >20 mm with nodal involvement, both highly significant.

Conclusions: Older age, lesion <20 mm, and no residual lesion predict absence of invasion and no nodal involvement in VABB-diagnosed DCIS. However it would be imprudent to routinely forego sentinel node biopsy in such patients as non-negligible proportions of them have invasive disease.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Biopsy
  • Breast / pathology*
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / surgery
  • Female
  • Humans
  • Lymphatic Metastasis
  • Mammography
  • Mastectomy
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Retrospective Studies
  • Risk Factors
  • Sentinel Lymph Node Biopsy
  • Tumor Burden
  • Vacuum