F. Warnberg et al., Ductal carcinoma in situ of the breast from a population-defined cohort: an evaluation of new histopathological classification systems, EUR J CANC, 35(5), 1999, pp. 714-720
The increased incidence of ductal carcinoma in situ of the breast (DCIS) in
the era of mammography screening requires a deeper knowledge of the biolog
y of the disease and calls for a suitable classification system to optimise
therapy. Our aim was to evaluate the correlation to prognosis for two new
classification systems of DCIS. The histopathological specimens from 195 wo
men consecutively diagnosed between 1986 and 1994 with a primary DCIS were
re-classified by two separate observers using the system proposed by an Eur
opean Organization for Research and Treatment of Cancer (EORTC) working gro
up and the Van Nuys system. The relapse-free survival (RFS) by histopatholo
gical subgroup and by nuclear grade only was estimated for women treated wi
th breast conserving surgery (n = 149). Thirty-two local recurrences occurr
ed among 149 women (mean follow-up time 59 months). No distant recurrences
or breast cancer deaths were reported. The women in the group with the high
est differentiation according to the EORTC classification had no recurrence
s. RFS did not differ appreciably between the two other groups. This was tr
ue also after stratification for radiotherapy. We found no statistically si
gnificant difference in RFS between the three groups in the Van Nuys classi
fication. There was an overall agreement between the observers in 79% and 6
4% of the cases, according to the EORTC and Van Nuys systems, respectively.
We were able to define one group with highly differentiated lesions and an
excellent prognosis with the EORTC classification. Further classification
into intermediate and low differentiated lesions did not help predict RFS.
(C) 1999 Elsevier Science Ltd. All rights reserved.