Takayuki Iwamoto
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Breast and Thyroid Surgery,
   Position   Assistant Professor
Article types 原著
Language English
Peer review Peer reviewed
Title A model to predict upstaging to invasive carcinoma in patients preoperatively diagnosed with ductal carcinoma in situ of the breast.
Journal Formal name：Journal of surgical oncology
Abbreviation：J Surg Oncol
ISSN code：10969098/00224790
Domestic / ForeginForegin
Volume, Issue, Page 112(5),pp.476-80
Author and coauthor 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
Publication date 2015/10
Summary 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