イワモト　タカユキ   Takayuki Iwamoto   岩本　高行    所属   川崎医科大学  医学部 臨床医学　乳腺甲状腺外科学    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	A model to predict upstaging to invasive carcinoma in patients preoperatively diagnosed with ductal carcinoma in situ of the breast.
掲載誌名	正式名：Journal of surgical oncology 略　 称：J Surg Oncol ISSNコード：10969098/00224790
掲載区分	国外
巻・号・頁	112(5),pp.476-80
著者・共著者	Takafumi Kondo, Naoki Hayashi, Sachiko Ohde, Koyu Suzuki, Atsushi Yoshida, Hiroshi Yagata, Naoki Niikura, Takayuki Iwamoto, Kumiko Kida, Michiko Murai, Yuko Takahashi, Hiroko Tsunoda, Seigo Nakamura, Hideko Yamauchi
発行年月	2015/10
概要	BACKGROUND: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.METHODS:Pre- and post-operative pathological diagnoses and radiological findings were assessed for 1,187 consecutive patients.RESULTS: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, P = 0.013); 2) pleomorphic calcifications on the mammogram (OR 1.68, P = 0.009); 3) a mass suspicious for invasive carcinoma on ultrasonography and/or MRI (OR 2.13, P < 0.001); 4) tumor size ≥2 cm on ultrasonography (OR 1.80, P = 0.032). HER2-positive (OR 1.54, P = 0.062) and comedo necrosis (OR 1.42, P = 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.CONCLUSIONS:The prediction model incorporating clinicopathological features may be used to guide the selection of patients with DCIS for sentinel lymph node biopsy.
DOI	10.1002/jso.24037
PMID	26346047