Ah Young Park1, Hye Mi Gweon1, Eun Ju Son1, Miri Yoo1, Jeong-Ah Kim1, Ji Hyun Youk2. 1. Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. 2. Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: jhyouk@yuhs.ac.
Abstract
OBJECTIVES: To identify preoperative features that could be used to predict invasive breast cancer in women with a diagnosis of ductal carcinoma in situ (DCIS) at ultrasound (US)-guided 14-gauge core needle biopsy (CNB). METHODS: A total of 86 DCIS lesions that were diagnosed at US-guided 14-gauge CNB and excised surgically in 84 women were assessed. We retrospectively reviewed the patients' medical records, mammography, US, and MR imaging. We compared underestimation rates of DCIS for the collected clinical and radiologic variables and determined the preoperative predictive factors for upstaging to invasive cancer. RESULTS: Twenty-seven (31.4%) of 86 DCIS lesions were upgraded to invasive cancer. Preoperative features that showed a significantly higher underestimation of DCIS were palpability or nipple discharge (p=0.040), number of core specimens less than 5 (p=0.011), mammographic maximum lesion size of 25 mm or larger (p=0.022), mammographic mass size of 40 mm or larger (p=0.046), sonographic mass size of 32 mm or larger (p=0.009), lesion size of 30 mm on MR (p=0.004), lower signal intensity (SI) on fat-saturated T2-weighted MR images (FS-T2WI) (p=0.005), heterogeneous or rim enhancement on MR images (p=0.009), and apparent diffusion coefficient (ADC) values lower than 1.04 × 10(-3)mm(2)/s on diffusion-weighted MR imaging (DWI) (p<0.001). CONCLUSION: Clinical symptom of palpability or nipple discharge, number of core specimen, mammographic maximum lesion or mass size, SI on FS-T2WI, heterogeneous or rim enhancement on MR, and ADC value may be helpful in predicting the upgrade to invasive breast cancer for DCIS diagnosed at US-guided 14-gauge CNB.
OBJECTIVES: To identify preoperative features that could be used to predict invasive breast cancer in women with a diagnosis of ductal carcinoma in situ (DCIS) at ultrasound (US)-guided 14-gauge core needle biopsy (CNB). METHODS: A total of 86 DCIS lesions that were diagnosed at US-guided 14-gauge CNB and excised surgically in 84 women were assessed. We retrospectively reviewed the patients' medical records, mammography, US, and MR imaging. We compared underestimation rates of DCIS for the collected clinical and radiologic variables and determined the preoperative predictive factors for upstaging to invasive cancer. RESULTS: Twenty-seven (31.4%) of 86 DCIS lesions were upgraded to invasive cancer. Preoperative features that showed a significantly higher underestimation of DCIS were palpability or nipple discharge (p=0.040), number of core specimens less than 5 (p=0.011), mammographic maximum lesion size of 25 mm or larger (p=0.022), mammographic mass size of 40 mm or larger (p=0.046), sonographic mass size of 32 mm or larger (p=0.009), lesion size of 30 mm on MR (p=0.004), lower signal intensity (SI) on fat-saturated T2-weighted MR images (FS-T2WI) (p=0.005), heterogeneous or rim enhancement on MR images (p=0.009), and apparent diffusion coefficient (ADC) values lower than 1.04 × 10(-3)mm(2)/s on diffusion-weighted MR imaging (DWI) (p<0.001). CONCLUSION: Clinical symptom of palpability or nipple discharge, number of core specimen, mammographic maximum lesion or mass size, SI on FS-T2WI, heterogeneous or rim enhancement on MR, and ADC value may be helpful in predicting the upgrade to invasive breast cancer for DCIS diagnosed at US-guided 14-gauge CNB.
Authors: Monica L Huang; Kenneth Hess; Rosalind P Candelaria; Mohammad Eghtedari; Beatriz E Adrada; Nour Sneige; Bruno D Fornage Journal: Eur Radiol Date: 2016-11-14 Impact factor: 5.315
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: Ern Yu Tan; Z W Joseph Lo; Chuan Han Ang; Christine Teo; Melanie D W Seah; Juliana J C Chen; Patrick M Y Chan Journal: Int Sch Res Notices Date: 2014-10-29
Authors: Kwan Ho Lee; Jeong Woo Han; Eun Young Kim; Ji Sup Yun; Yong Lai Park; Chan Heun Park Journal: BMC Cancer Date: 2019-12-10 Impact factor: 4.430