OBJECTIVES: The present study tried to identify factors predictive of upstaging from ultrasound-guided core needle biopsy (CNB)-diagnosed ductal carcinoma in situ (DCIS) to invasive cancer after surgical excision. MATERIALS AND METHODS: We enrolled 506 female CNB-diagnosed DCIS patients who underwent subsequent surgical excision between January 2000 and February 2011. A retrospective analysis of patients undergone core needle biopsy and subsequent surgical excision was performed. Ultrasonography guided CNB was performed using either an 8-, 11-gauge vacuum-assisted method, or a 14-gauge needle automated gun method. RESULTS: The overall upstaging rate was 42.7% (216/506). Multivariate analysis found that a palpable lesion, a lesion size >20 mm, a high grade lesion, and use of the 14-gauge needle method were independently associated with upstaging (p < 0.05 for all variables). We designed a scoring system to predict lymph node positivity in these patients, and the subsequent ROC curve showed an AUC value of 0.746 (p < 0.001, 95% CI: 0.66-0.82). Patient with a non-high grade lesion that was ≤20 mm in size carried no risk of lymph node positivity. CONCLUSION: 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.
OBJECTIVES: The present study tried to identify factors predictive of upstaging from ultrasound-guided core needle biopsy (CNB)-diagnosed ductal carcinoma in situ (DCIS) to invasive cancer after surgical excision. MATERIALS AND METHODS: We enrolled 506 female CNB-diagnosed DCISpatients who underwent subsequent surgical excision between January 2000 and February 2011. A retrospective analysis of patients undergone core needle biopsy and subsequent surgical excision was performed. Ultrasonography guided CNB was performed using either an 8-, 11-gauge vacuum-assisted method, or a 14-gauge needle automated gun method. RESULTS: The overall upstaging rate was 42.7% (216/506). Multivariate analysis found that a palpable lesion, a lesion size >20 mm, a high grade lesion, and use of the 14-gauge needle method were independently associated with upstaging (p < 0.05 for all variables). We designed a scoring system to predict lymph node positivity in these patients, and the subsequent ROC curve showed an AUC value of 0.746 (p < 0.001, 95% CI: 0.66-0.82). Patient with a non-high grade lesion that was ≤20 mm in size carried no risk of lymph node positivity. CONCLUSION: 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.
Authors: Carlos Chavez de Paz Villanueva; Valentina Bonev; Maheswari Senthil; Naveenraj Solomon; Mark E Reeves; Carlos A Garberoglio; Jukes P Namm; Sharon S Lum Journal: JAMA Surg Date: 2017-11-01 Impact factor: 14.766
Authors: Michael R Harowicz; Ashirbani Saha; Lars J Grimm; P Kelly Marcom; Jeffrey R Marks; E Shelley Hwang; Maciej A Mazurowski Journal: J Magn Reson Imaging Date: 2017-02-09 Impact factor: 4.813
Authors: Tawakalitu O Oseni; Barbara L Smith; Constance D Lehman; Charmi A Vijapura; Niveditha Pinnamaneni; Manisha Bahl Journal: Ann Surg Oncol Date: 2020-05-16 Impact factor: 5.344