[Decision making factors of the management of ductal carcinoma in situ of the breast with microinvasion]

Bull Cancer. 2019 Nov;106(11):1000-1007. doi: 10.1016/j.bulcan.2019.05.005. Epub 2019 Jul 24.
[Article in French]

Abstract

Introduction: Microinvasive in situ ductal carcinomas of the breast are rare and of good prognosis. They are grouped with early stage invasive carcinomas in the TNM 2017 classification. This study assessed practitioners' treatment decisions and their justifications in comparison to the literature.

Materials and methods: Three clinical cases were evaluated by anonymous forms regarding sentinel node decisions, tumour bed boost irradiation and hormone therapy.

Results: Sentinel lymph node was performed by 93.1%, 100% and 44.4% of the practitioners respectively. Radiation boost was a treatment option chosen by 62.1% and 61.1% of practitioners in both clinical cases. Hormone therapy was advocated for 65.5%, 94.7% and 50.0% patients depending on the clinical case.

Conclusion: The therapeutic attitude proposed in microinvasive breast carcinomas was heterogeneous in this study, reflecting the absence of specific recommendations. In view of the existing literature, it is not currently possible to propose recommendations for these three therapeutic options. Prospective cohorts and meta-analyses of the microinvasive subgroup could provide answers.

Keywords: Boost; Breast; Cancer; Ganglion sentinelle; Hormone; Hormonothérapie; In situ; Micro-invasion; Microinvasion; SLNB; Sein; Surimpression.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adult
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Carcinoma, Intraductal, Noninfiltrating / therapy*
  • Clinical Decision-Making*
  • Female
  • Health Care Surveys
  • Humans
  • Mastectomy / statistics & numerical data
  • Middle Aged
  • Neoplasm Invasiveness
  • Oncologists / statistics & numerical data
  • Prognosis
  • Radiologists / statistics & numerical data
  • Radiotherapy, Adjuvant / statistics & numerical data
  • Sentinel Lymph Node Biopsy / statistics & numerical data*
  • Surgeons / statistics & numerical data

Substances

  • Antineoplastic Agents, Hormonal