Is palpable DCIS more aggressive than screen-detected DCIS?

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Palpable ductal carcinoma in-situ (pDCIS) is a subset of ductal carcinoma in-situ (DCIS) that presents as a distinct clinical mass.
• This presentation suggests potentially more aggressive disease characteristics compared to screen-detected DCIS.

Purpose of the Study:

• To investigate whether palpable DCIS (pDCIS) exhibits more aggressive clinical and pathological features.
• To compare rates of recurrence and upgrade to invasive disease between pDCIS and screen-detected DCIS.

Main Methods:

• Retrospective analysis of female patients diagnosed with DCIS via core-needle biopsy.
• Comparison of clinical and pathological features between patients with pDCIS (palpable mass) and screen-detected DCIS.
• Descriptive statistics and multivariate analysis to identify significant differences.

Main Results:

• pDCIS cases were associated with larger lesion size and more frequent ultrasound-guided biopsies.
• Multivariate analysis linked pDCIS to ultrasound-guided biopsy, DCIS size >2 cm, and comedo pattern.
• No significant difference was observed in the upgrade rate to invasive cancer (7.7% for pDCIS vs. 3.5% for screen-detected) or local recurrence rates between the groups.

Conclusions:

• pDCIS demonstrates certain aggressive pathological and clinical features and is more commonly diagnosed via ultrasound-guided biopsy.
• Despite these associations, pDCIS does not show a significantly higher rate of recurrence or upgrade to invasive disease compared to screen-detected DCIS.