Breast Flashcards
DCIS microinvasion definition?
Invasion of basement membrane, < 1mm
T1 mi stage
DCIS growth patterns?
Solid, Cribriform, Papillary, Micropapillary
DCIS high- risk features?
High grade
Tumor infiltrating lymphocytes
Periductal fibrosis
Size
DCIS mammographic features?
Microcalcifications
Linear branching type (usually higher grade)
Fine, granular (usually lower grade)
DCIS multicentric definition?
> 5cm from index lesion or discontinuous growth in another quadrant
DCIS upgrade rate on core bx?
20%
DCIS recurrence rates?
Mastectomy (2.6%)
BCT with RT (13.6%)
BCT with RT and Tamoxifen (9.7%)
No survival benefit to mastectomy
Benefit of RT in DCIS?
NSABP B-17, RTOG 9804
Reduces both invasive and non-invasive tumors by 50-70%
Benefit of endocrine threapy in DCIS?
NSABP B-24
50% reduction in breast cancer with Tamoxifen for 5 years
Tamoxifen vs anastrozole for DCIS?
NSABP 35
Anastrozole superior in < 60 yrs
LCIS risk of cancer %/yr?
1% per year
Indications for Oncotype?
- 0.5-5 cm HR + tumor
- 1-3 positive axillary nodes
MRI for DCIS?
Does not increase negative margins or decrease mastectomy
Percentage of recurrence after dcis surgery that are invasive?
50 %
MRI for DCIS?
Does not increase negative margins or decrease mastectomy