OCCURENCE OF CARCINOMA IN SITU IN ASSOCIATION WITH INVASIVE CANCER OF BREAST

The objectives of this study were to find out the frequency and the pattern of carcinoma in situ occurring in association with different types of breast cancers. This study was conducted in the Department of Clinical Oncology and the Department of Pathology, King Edward Medical University / Mayo Hospital, Lahore on breast cancer patients diagnosed between 1st January 2001 and 31st December 2005. The age, menopausal status, histopathological type, grade, and presence or absence of carcinoma in situ were recorded. Histopathological features were recorded according to WHO system. Grade was recorded only when it was assigned according to the Elston-Ellis modification of Scarff-Bloom-Richardson grading system. A total of 1230 histopathologically documented invasive and non-invasive breast cancers patients were included in the study. DCIS alone was seen in seven patients (00.57%) and LCIS alone in two patients (00.16%). Invasive ductal carcinoma was seen in 998 patients (81.14%) and invasive lobular carcinoma in 96 patients (07.80%). Majority of breast cancers were grade II whereas grade I seen in 23.90% patients only. Areas of carcinoma in situ in different types of invasive cancers were seen in 328 (26.86%) patients. Majority of these patients were below 50 years of age. DCIS was present in 246 of 998 patients (24.65%) of invasive ductal carcinoma (NOS). Comedo pattern was seen in 154 of 290 (53.10%) of DCIS. LCIS was present in 38 of 96 patients (39.58%) of invasive lobular carcinoma. Carcinoma in situ of breast is a rarely diagnosed disease entity in our setting. It is seen mostly in association with invasive carcinoma of breast cancer. Ductal carcinoma in situ with comedo pattern is most frequent.