早期浸润性导管癌 (IDC) 乳腺癌通常存在共存​​的导管原位癌 (DCIS) 成分，而约 5% 的病例存在广泛 (>25%) 导管内成分 (EIC)。 EIC 对基因组复发风险的影响尚不清楚。在我们研究所接受乳房手术的早期激素受体阳性 HER2neu 阴性 (HR  HER2-) IDC 乳腺癌患者和已知 OncotypeDX 乳房复发评分® (RS) 的患者包括。使用基于规则的文本分析算法，我们分析了病理报告并将患者分为三组：EIC、非广泛性 DCIS (DCIS-L) 和纯 IDC (NO-DCIS)。使用 OncotypeDX RS 确定基因组风险。总共确定了 33 例 (4.6%) EIC 病例、377 例 (57.2%) DCIS-L 病例和 307 例 (42.8%) NO-DCIS 病例。 EIC 组的患者比其他组更年轻，肿瘤分级也更低。各组之间的基因组风险分布各不相同，与 DCIS-L 和非 DCIS 肿瘤相比，EIC 肿瘤具有高 RS (>25) 的可能性明显较低（分别为 3% vs 20% 和 20%；p = 0.03 ）。当根据年龄、肿瘤大小、分级和淋巴结受累进行调整时，与 EIC 组相比，DCIS-L 和 NO-DCIS 组均与较高的高 RS 概率显着相关（分别为 OR 12.3 和 OR 13.1；p < 0.02） 。此外，EIC 患者接受辅助化疗的可能性较低。在早期 HR HER2-IDC 中，EIC 与基因组复发风险降低相关。对基因组风险的影响似乎受到 DCIS 的程度的影响，而不仅仅是其存在。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Early invasive ductal carcinoma (IDC) breast cancer often presents with a coexisting ductal carcinoma in situ (DCIS) component, while about 5 % of cases present with an extensive (>25 %) intraductal component (EIC). The impact of EIC on the genomic risk of recurrence is unclear.Patients with early hormone receptor-positive HER2neu-negative (HR + HER2-) IDC breast cancer and a known OncotypeDX Breast Recurrence Score® (RS) who underwent breast surgery at our institute were included. Using a rule-based text-analysis algorithm, we analyzed pathological reports and categorized patients into three groups: EIC, non-extensive DCIS (DCIS-L), and pure-IDC (NO-DCIS). Genomic risk was determined using OncotypeDX RS.A total of 33 (4.6 %) EIC cases, 377 (57.2 %) DCIS-L cases and 307 (42.8 %) NO-DCIS cases were identified. Patients in the EIC group were younger and had lower tumor grades than other groups. The distribution of genomic risk varied between the groups, with EIC tumors significantly less likely to have a high RS (>25) compared to DCIS-L and No-DCIS tumors (3 % vs 20 % and 20 %, respectively; p = 0.03). When adjusted to age, tumor size, grade and LNs involvement, both DCIS-L and NO-DCIS groups were significantly correlated with a higher probability of high RS compared to the EIC group (OR 12.3 and OR 13.1, respectively; p < 0.02). Moreover, patients with EIC had a lower likelihood for adjuvant chemotherapy recommendation.In early HR + HER2- IDC, an EIC correlates with a reduced genomic recurrence risk. The impact on genomic risk seems to be influenced by the extent, not merely the presence, of DCIS.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.