Approach of ductal carcinoma in situ of the breast in three public hospitals in Belo Horizonte - Revista Brasileira de Ginecologia e Obstetrícia

PURPOSE: to evaluate the clinical, radiological therapeutic and anatomo-pathological aspects in a series of patients with breast ductal carcinoma in situ (DCIS), attended in three public hospitals in Belo Horizonte (MG). METHODS: 179 cases of DCIS, that were selected from all the patients who had been diagnosed with breast cancer between 1985 and 2000, were studied retrospectively. After reviewing all the tissue sections, it was possible to collect all the clinical data, mammogram and treatment information of 85 cases. RESULTS: most patients were not symptomatic and the diagnosis had been done by mammogram (68.2%), being the microcalcification the most common radiological alteration. There has been a progressive increase in the diagnosis of DCIS along the years, following the introduction of periodical mammographic screening. The initial histopathological diagnosis and the review agreed in 72.9% of cases. In three cases, the original diagnosis of DCIS was not confirmed, being classified as atypical hyperplasia. Mammogram microcalcifications were confirmed in the pathological analysis in 95.6% of cases. Half of the patients was treated with mastectomy. All lymph nodes from axillary dissection were negative for metastases. CONCLUSIONS: The present study is in agreement with the recent literature, which shows an increase in the diagnosis of DCIS since 1990. There has been a great interobserver variation since the initial pathological diagnosis, which tended to malignancy and the present review. There were a great number of radical treatments, such as mastectomy and axillary dissection, which would probably be replaced by conservative treatment and sentinel lymph node biopsy nowadays, according to recent knowledge.