Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy to invasive cancer in subsequent surgical excision

Kim, Ji Sun; Han, Wonshik; Lee, Jong Won; You, Jee-Man; Shin, Hyungcheol; Ahn, Seung-Ho; Moon, Hyeong‐Gon; Cho, Nariya; Moon, Woo Kyung; Park, In-ae; Noh, Dong‐Young

doi:10.1016/j.breast.2012.06.012

Cited by 70 publications

(84 citation statements)

References 19 publications

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“…HG-DCIS, in comparison to non-high-grade counterparts, has a significantly higher rate of recurrence. 23,24 Recurrence tends to occur earlier and more often as invasive carcinoma. 25,26 Likewise, high nuclear grade in DCIS on biopsy specimens is, among other factors, a significant risk factor for invasive carcinoma on excision.…”

Section: Discussionmentioning

confidence: 98%

“…25,26 Likewise, high nuclear grade in DCIS on biopsy specimens is, among other factors, a significant risk factor for invasive carcinoma on excision. 24,27 The role of changes associated with tumor regression in predicting HG-DCIS recurrence has been explored, with mixed results. Some authors identified that periductal inflammation and fibrosis are significantly associated with tumor recurrence and invasive carcinoma on excision.…”

Section: Discussionmentioning

confidence: 99%

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Regressive Change in High-Grade Ductal Carcinoma In Situ of the Breast

Wasserman

Parra‐Herran

2015

American Journal of Clinical Pathology

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Regressive Change in High-Grade Ductal Carcinoma In Situ of the Breast

Wasserman

Parra‐Herran

2015

American Journal of Clinical Pathology

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“…The two models were selected using data of the meta-analysis study [1] and the multivariate analysis study [2]. Selected meta-analysis study was the only study of that kind reported prior to the period of research, and we selected the largest Korean study among the many multivariate analysis studies.…”

Section: Case Descriptionmentioning

confidence: 99%

“…The multivariate analysis study [2] showed 216 cases of invasive cancer among 506 cases of DCIS. The model of the multivariate analysis study is given as…”

Section: Case Descriptionmentioning

confidence: 99%

“…In this study, we developed two Web-based nomograms to predict the postoperative invasive component in DCIS at core needle biopsy using the existing references of a meta-analysis study [1] and a multivariate analysis study [2] and compared the two nomograms in terms of validation of reliability and discrimination using the data of the authors' affiliation.…”

Section: Introductionmentioning

confidence: 99%

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Development and Validation of Web-Based Nomograms to Predict Postoperative Invasive Component in Ductal Carcinomain Situat Needle Breast Biopsy

Lee

Chang

2014

Healthc Inform Res

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ObjectivesAlthough sonography-guided core needle biopsy is a highly targeted method, there is a possibility of an invasive component after surgical excision of ductal carcinoma in situ (DCIS) of the breast. This study was performed to develop and validate nomograms to predict the postoperative invasive component in DCIS at core needle biopsy.MethodsTwo nomograms were developed using the data of previous meta-analysis and multivariate analysis. Nomograms were validated externally using the data of the authors' affiliation. The accuracy was validated by the expected-to-observed ratio and the Hosmer-Lemeshow goodness-of-fit test. Discrimination was validated by the area under the curve (AUC) of receiver operating characteristic (ROC) curve analysis.ResultsThe nomogram using the meta-analysis study data was developed at http://dcis-m.surgery.kr.pe/, and the nomogram using the multivariate analysis study data was developed at http://dcis-k.surgery.kr.pe/. The Hosmer-Lemeshow goodness-of-fit test showed that the nomogram using multivariate analysis data (p = 0.131) was better calibrated than that using meta-analysis data (p < 0.001). ROC curve analysis showed statistically significant power of discrimination in both nomograms (AUC = 0.776, 0.751).ConclusionsBoth nomograms showed statistically significant discriminatory power, but the nomogram using the data of multivariate analysis was simpler and more reliable. These would be useful for the prediction of invasive cancer and the need for sentinel node biopsy in DCIS at core needle biopsy.

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Factors Associated With Underestimation of Invasive Cancer in Patients With Ductal Carcinoma In Situ

et al. 2017

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IMPORTANCE Recent recognition of the overdiagnosis and overtreatment of ductal carcinoma in situ (DCIS) detected by mammography has led to the development of clinical trials randomizing women with non-high-grade DCIS to active surveillance, defined as imaging surveillance with or without endocrine therapy, vs standard surgical care.OBJECTIVE To determine the factors associated with underestimation of invasive cancer in patients with a clinical diagnosis of non-high-grade DCIS that would preclude active surveillance. DESIGN, SETTING, AND PARTICIPANTSA retrospective cohort study was conducted using records from the National Cancer Database from January 1, 1998, to December 31, 2012, of female patients 40 to 99 years of age with a clinical diagnosis of non-high-grade DCIS who underwent definitive surgical treatment. Data analysis was conducted from November 1, 2015, to February 4, 2017.EXPOSURES Patients with an upgraded diagnosis of invasive carcinoma vs those with a diagnosis of DCIS based on final surgical pathologic findings. MAIN OUTCOMES AND MEASURESThe proportions of cases with an upgraded diagnosis of invasive carcinoma from final surgical pathologic findings were compared by tumor, host, and system characteristics. RESULTSOf 37 544 women (mean [SD] age, 59.3 [12.4] years) presenting with a clinical diagnosis of non-high-grade DCIS, 8320 (22.2%) had invasive carcinoma based on final pathologic findings. Invasive carcinomas were more likely to be smaller (>0.5 to Յ1.0 cm vs Յ0.

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Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy to invasive cancer in subsequent surgical excision

Abstract: Upstaging was associated with lesions that were large, palpable or high grade. It was also associated with use of the 14-gauge needle method. Our scoring system might be helpful to identify patients who do not require sentinel lymph node biopsy.

Cited by 70 publications

References 19 publications

Regressive Change in High-Grade Ductal Carcinoma In Situ of the Breast

Regressive Change in High-Grade Ductal Carcinoma In Situ of the Breast

Development and Validation of Web-Based Nomograms to Predict Postoperative Invasive Component in Ductal Carcinomain Situat Needle Breast Biopsy

Factors Associated With Underestimation of Invasive Cancer in Patients With Ductal Carcinoma In Situ

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