INTRADUCTAL EXTENSION OF PRIMARY INVASIVE BREAST-CARCINOMA TREATED BYBREAST-CONSERVATIVE SURGERY - COMPUTER GRAPHIC 3-DIMENSIONAL RECONSTRUCTION OF THE MAMMARY DUCT-LOBULAR SYSTEMS
T. Ohtake et al., INTRADUCTAL EXTENSION OF PRIMARY INVASIVE BREAST-CARCINOMA TREATED BYBREAST-CONSERVATIVE SURGERY - COMPUTER GRAPHIC 3-DIMENSIONAL RECONSTRUCTION OF THE MAMMARY DUCT-LOBULAR SYSTEMS, Cancer, 76(1), 1995, pp. 32-45
Background. Intraductal tumor extension is a characteristic feature of
primary breast carcinoma, and is an important consideration in patien
ts undergoing breast conservative surgery. However, there have been no
reports of studies of intraductal extension within the mammary ductal
tree. Methods. Quadrantectomy specimens from 20 patients with primary
invasive breast carcinoma were examined by subgross and stereomicrosc
opic technique to visualize intraductal tumor extension. Serial 2 mm-t
hick sections were subjected to two-dimensional (2-D) tumor mapping, m
easuring the distances and angles of extension, and to three-dimension
al (3-D) reconstruction of the mammary duct-lobular systems by means o
f computer graphics. Results. Intraductal tumor extension was found in
16 of 20 specimens (80.0%), extending continuously from the primary i
nvasive carcinoma through the mammary ductal tree. The distances and a
ngles of extension were larger in tumors with microcalcifications, pap
illotubular invasive ductal carcinoma, 30% or more of intraductal comp
onent, and comedo-type intraductal tumor extension. The 3-D reconstruc
tions demonstrated three types of extension; central(ll cases), periph
eral (3 cases), and mixed (2 cases). Further, there were some ductal b
ranches anastomosing with different mammary duct-lobular systems at va
rious sites. In one specimen, intraductal tumor extended widely from t
he primary invasive carcinoma through a branch connecting adjacent mam
mary duct-lobular systems. Conclusions. Three-dimensional reconstructi
on images of intraductal extension of invasive breast carcinomas are p
resented for the first time to the authors' knowledge. Examples of duc
tal anastomoses were observed, and should be considered as a risk fact
or for possible widespread intraductal extension through multiple mamm
ary duct-lobular systems.