A model to predict upstaging to invasive carcinoma in patients preoperatively diagnosed with ductal carcinoma in situ of the breast. Issue 5 (8th September 2015)

• Record Type: Journal Article
• Authors: Kondo, Takafumi; Hayashi, Naoki; Ohde, Sachiko; Suzuki, Koyu; Yoshida, Atsushi; Yagata, Hiroshi; Niikura, Naoki; Iwamoto, Takayuki; Kida, Kumiko; Murai, Michiko; Takahashi, Yuko; Tsunoda, Hiroko; Nakamura, Seigo; Yamauchi, Hideko
• Is Part Of: Journal of surgical oncology. Volume 112:Issue 5(2015:Oct. 01)
• Page Start: 476
• Page End: 480
• Publication Date: 2015-09-08
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.24037
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso24037-sec-0001" sec-type="section"> <title>Background</title> <p>The aims of this study were to determine clinicopathological factors associated with postoperative upstaging to invasive carcinoma in patients preoperatively diagnosed with ductal carcinoma in situ (DCIS) and to develop a model to predict the risk of upstaging.</p> </sec> <sec id="jso24037-sec-0002" sec-type="section"> <title>Methods</title> <p>Pre‐ and post‐operative pathological diagnoses and radiological findings were assessed for 1, 187 consecutive patients.</p> </sec> <sec id="jso24037-sec-0003" sec-type="section"> <title>Results</title> <p>Of the patients, 306 (25.8%) were upstaged on the surgical specimen. In multivariate analysis, the following four factors were significantly associated with upstaging: 1) the presence of sclerosing adenosis on the preoperative biopsy specimen (odds ratio [OR] 0.46, <italic>P</italic> = 0.013); 2) pleomorphic calcifications on the mammogram (OR 1.68, <italic>P</italic> = 0.009); 3) a mass suspicious for invasive carcinoma on ultrasonography and/or MRI (OR 2.13, <italic>P</italic> < 0.001); 4) tumor size ≥2 cm on ultrasonography (OR 1.80, <italic>P</italic> = 0.032). HER2‐positive (OR 1.54, <italic>P</italic> = 0.062) and comedo necrosis (OR 1.42, <italic>P</italic> = 0.056) demonstrated a trend towards significance. A prediction model incorporating these variables demonstrated that the risk of upstaging was 5.1% with score 0–2 and was 58.1% with score 10.</p> </sec> <sec id="jso24037-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The prediction model incorporating clinicopathological features may be used to guide the selection of patients with DCIS for sentinel lymph node biopsy. <italic>J. Surg. Oncol. 2015; 112:476–480</italic>. © 2015 Wiley Periodicals, Inc.</p> </sec> </abstract>