Abstract：
OBJECTIVE: The method of diagnosis of ductal carcinoma in situ (DCIS) has changed since the 1980s. The aim of this audit was to assess changes in the preoperative diagnosis of DCIS since the introduction of needle core biopsy, particularly the proportion with a preoperative biopsy diagnosis of DCIS.
RESULTS: The preoperative diagnoses of patients with a final diagnosis of DCIS in the surgical specimen were reviewed (i) in 809 patients who presented through breast screening from 1997 to 2021, and (ii) in all patients in 5 individual years at 5-year intervals from 2000 to 2020 (254 in total). For screening-detected DCIS the proportion with a preoperative diagnosis of DCIS increased from 75% to 98% over the study period. In a detailed analysis of all cases of DCIS in 5 separate years the proportion with a preoperative diagnosis of DCIS increased from 68% in 2000 to 96% in 2020. For high-grade DCIS the proportion increased from 87% to 97%, and for low- or intermediate-grade DCIS from 48% to 93%. The proportion of women who had vacuum-assisted biopsy increased from 7% in 2000 to 58% in 2015. There was a small increase in the number of biopsies that had basal cytokeratin and oestrogen receptor immunohistochemistry to aid diagnosis.
CONCLUSIONS: There has been an increase in the preoperative diagnosis of DCIS, particularly of low- or intermediate-grade, over the last two decades. The increasing use of vacuum-assisted biopsy is likely to be a major contributory factor to this increase.
RESULTS: The preoperative diagnoses of patients with a final diagnosis of DCIS in the surgical specimen were reviewed (i) in 809 patients who presented through breast screening from 1997 to 2021, and (ii) in all patients in 5 individual years at 5-year intervals from 2000 to 2020 (254 in total). For screening-detected DCIS the proportion with a preoperative diagnosis of DCIS increased from 75% to 98% over the study period. In a detailed analysis of all cases of DCIS in 5 separate years the proportion with a preoperative diagnosis of DCIS increased from 68% in 2000 to 96% in 2020. For high-grade DCIS the proportion increased from 87% to 97%, and for low- or intermediate-grade DCIS from 48% to 93%. The proportion of women who had vacuum-assisted biopsy increased from 7% in 2000 to 58% in 2015. There was a small increase in the number of biopsies that had basal cytokeratin and oestrogen receptor immunohistochemistry to aid diagnosis.
CONCLUSIONS: There has been an increase in the preoperative diagnosis of DCIS, particularly of low- or intermediate-grade, over the last two decades. The increasing use of vacuum-assisted biopsy is likely to be a major contributory factor to this increase.
摘要：
目的：自1980年代以来，导管原位癌（DCIS）的诊断方法发生了变化。本次审核的目的是评估自引入针芯活检以来DCIS术前诊断的变化，特别是术前活检诊断为DCIS的比例。
结果：对手术标本中最终诊断为DCIS的患者的术前诊断进行了回顾：（i）在1997年至2021年通过乳腺筛查的809例患者中，以及（ii）在2000年至2020年的5个个体年中的所有患者（共254例）。对于筛查检测到的DCIS，术前诊断为DCIS的比例在研究期间从75％增加到98％。在对5年内所有DCIS病例的详细分析中，术前诊断为DCIS的比例从2000年的68％增加到2020年的96％。对于高级DCIS，比例从87%增加到97%，低档或中档DCIS从48%到93%。接受真空辅助活检的女性比例从2000年的7%增加到2015年的58%。具有基底细胞角蛋白和雌激素受体免疫组织化学以帮助诊断的活检数量略有增加。
结论：DCIS的术前诊断有所增加，特别是低等或中等等级的，在过去的二十年里。越来越多地使用真空辅助活检可能是导致这种增加的主要因素。
结果：对手术标本中最终诊断为DCIS的患者的术前诊断进行了回顾：（i）在1997年至2021年通过乳腺筛查的809例患者中，以及（ii）在2000年至2020年的5个个体年中的所有患者（共254例）。对于筛查检测到的DCIS，术前诊断为DCIS的比例在研究期间从75％增加到98％。在对5年内所有DCIS病例的详细分析中，术前诊断为DCIS的比例从2000年的68％增加到2020年的96％。对于高级DCIS，比例从87%增加到97%，低档或中档DCIS从48%到93%。接受真空辅助活检的女性比例从2000年的7%增加到2015年的58%。具有基底细胞角蛋白和雌激素受体免疫组织化学以帮助诊断的活检数量略有增加。
结论：DCIS的术前诊断有所增加，特别是低等或中等等级的，在过去的二十年里。越来越多地使用真空辅助活检可能是导致这种增加的主要因素。
