ID 111180
Author
Kanematsu, Miyuki Shikoku Medical Center for Children and Adults Tokushima University Educator and Researcher Directory
Morimoto, Masami The University of Tokushima
Takahashi, Masako Tokushima Breast Care Clinic
Honda, Junko Higashi Tokushima Medical Center
Moriya, Takuya Kawasaki Medical School
Tadokoro, Yukiko The University of Tokushima KAKEN Search Researchers
Nakagawa, Misako The University of Tokushima KAKEN Search Researchers
Kajikawa, Aiichiro Shikoku Medical Center for Children and Adults
Sasa, Mitsunori Tokushima Breast Care Clinic
Keywords
low grade DCIS
Ki67 index
ER positive and HER2 negative
comedo-necrosis
mammography
Content Type
Journal Article
Description
Background Overdiagnosis in mammography (MMG) is a problem. Combination of MMG and ultrasonography for breast cancer screening may increase overdiagnosis. Most cases of overdiagnosis are low-grade ductal carcinoma in situ (LGD), but no reports have focused on them. Materials and methods We immunostained 169 ductal carcinoma in situ (DCIS) cases for ER, PgR, HER2 and Ki67 and classified them into 4 subtypes : ER(+)/ HER2(-), ER(+)/HER2(+), ER(-)/HER2(-) and ER(-)/HER2(+). The Ki67 index was used to evaluate the grade of malignancy and examined for correlations with each ER/HER2 subtype and the nuclear grade (NG), with/without comedo necrosis. Results The Ki67 index correlated significantly with NG, both with/without comedo necrosis, and reliably evaluated the grade of malignancy. The index for ER(+)/HER2(-) (n=117, 69.2%) was 7.45±7.10, which was significantly lower than for each of the other types. The index was 5.71±6.94 for ER(+)/HER2(-) without comedo necrosis (n=52, 30.8%), which was significantly lower than with comedo necrosis. This was considered LGD, characterized by absence of microcalcification in MMG and either presence of a solid mass or cystic lesion or absence of hypoechoic areas in ultrasound. Conclusion In Japan, ER(+)/HER2(-) without comedo necrosis accounts for about 30% of DCIS and is LGD. This may be being overdiagnosed.
Journal Title
The Journal of Medical Investigation
ISSN
13496867
13431420
NCID
AA11166929
AA12022913
Publisher
Faculty of Medicine Tokushima University
Volume
63
Issue
3-4
Start Page
192
End Page
198
Sort Key
192
Published Date
2016-08
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
University Hospital
Medical Sciences