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Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy.
Breast Cancer Res Treat. 2008 Nov; 112(1):189-95.BC

Abstract

BACKGROUND

The aim of this study was to determine factors that predict under-evaluation of malignancy in patients diagnosed with atypical ductal hyperplasia (ADH) at ultrasound-guided core needle biopsy (CNB), and to develop a prediction algorithm for scoring the possibility of a diagnosis upgrade to malignancy based on clinical, radiological and pathological factors.

METHODS

The study enrolled patients diagnosed with ADH at ultrasound-guided CNB who subsequently underwent surgical excision of the lesion. Multivariate analysis was used to identify relevant clinical, radiological and pathological factors that may predict malignancy.

RESULTS

A total of 102 patients with ADH at CNB were identified. Of the 74 patients who underwent subsequent surgical excision, 34 (45.8%) were diagnosed with invasive or in situ malignant foci. Multivariate analysis revealed that age>50 years, microcalcification on mammography, size on imaging>15 mm and a palpable lesion were independent predictors of malignancy. Focal ADH was a negative predictor. A scoring system was developed based on logistic regression models and beta coefficients for each variable. The area under the ROC curve was 0.903 (95% CI: 0.82-0.94), and the negative predictive value was 100% for a score<or=3.5. Similar findings were observed for a validation dataset of 54 patients at other institutions.

CONCLUSIONS

A scoring system to predict malignancy in patients diagnosed with ADH at CNB was developed based on five factors: age, palpable lesion, microcalcification on mammography, size on imaging and focal ADH. This system was able to identify a subset of patients with lesions likely to be benign, indicating that imaging follow-up rather than surgical excision may be appropriate.

Authors+Show Affiliations

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18060577

Citation

Ko, Eunyoung, et al. "Scoring System for Predicting Malignancy in Patients Diagnosed With Atypical Ductal Hyperplasia at Ultrasound-guided Core Needle Biopsy." Breast Cancer Research and Treatment, vol. 112, no. 1, 2008, pp. 189-95.
Ko E, Han W, Lee JW, et al. Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy. Breast Cancer Res Treat. 2008;112(1):189-95.
Ko, E., Han, W., Lee, J. W., Cho, J., Kim, E. K., Jung, S. Y., Kang, M. J., Moon, W. K., Park, I. A., Kim, S. W., Kim, K. S., Lee, E. S., Min, K. H., Kim, S. W., & Noh, D. Y. (2008). Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy. Breast Cancer Research and Treatment, 112(1), 189-95.
Ko E, et al. Scoring System for Predicting Malignancy in Patients Diagnosed With Atypical Ductal Hyperplasia at Ultrasound-guided Core Needle Biopsy. Breast Cancer Res Treat. 2008;112(1):189-95. PubMed PMID: 18060577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy. AU - Ko,Eunyoung, AU - Han,Wonshik, AU - Lee,Jong Won, AU - Cho,Jihyoung, AU - Kim,Eun-Kyu, AU - Jung,So-Youn, AU - Kang,Mee Joo, AU - Moon,Woo Kyung, AU - Park,In Ae, AU - Kim,Sung-Won, AU - Kim,Ku Sang, AU - Lee,Eun Sook, AU - Min,Kyu Hong, AU - Kim,Seok Won, AU - Noh,Dong-Young, Y1 - 2007/12/04/ PY - 2007/09/21/received PY - 2007/11/14/accepted PY - 2007/12/7/pubmed PY - 2008/12/17/medline PY - 2007/12/7/entrez SP - 189 EP - 95 JF - Breast cancer research and treatment JO - Breast Cancer Res Treat VL - 112 IS - 1 N2 - BACKGROUND: The aim of this study was to determine factors that predict under-evaluation of malignancy in patients diagnosed with atypical ductal hyperplasia (ADH) at ultrasound-guided core needle biopsy (CNB), and to develop a prediction algorithm for scoring the possibility of a diagnosis upgrade to malignancy based on clinical, radiological and pathological factors. METHODS: The study enrolled patients diagnosed with ADH at ultrasound-guided CNB who subsequently underwent surgical excision of the lesion. Multivariate analysis was used to identify relevant clinical, radiological and pathological factors that may predict malignancy. RESULTS: A total of 102 patients with ADH at CNB were identified. Of the 74 patients who underwent subsequent surgical excision, 34 (45.8%) were diagnosed with invasive or in situ malignant foci. Multivariate analysis revealed that age>50 years, microcalcification on mammography, size on imaging>15 mm and a palpable lesion were independent predictors of malignancy. Focal ADH was a negative predictor. A scoring system was developed based on logistic regression models and beta coefficients for each variable. The area under the ROC curve was 0.903 (95% CI: 0.82-0.94), and the negative predictive value was 100% for a score<or=3.5. Similar findings were observed for a validation dataset of 54 patients at other institutions. CONCLUSIONS: A scoring system to predict malignancy in patients diagnosed with ADH at CNB was developed based on five factors: age, palpable lesion, microcalcification on mammography, size on imaging and focal ADH. This system was able to identify a subset of patients with lesions likely to be benign, indicating that imaging follow-up rather than surgical excision may be appropriate. SN - 0167-6806 UR - https://www.unboundmedicine.com/medline/citation/18060577/Scoring_system_for_predicting_malignancy_in_patients_diagnosed_with_atypical_ductal_hyperplasia_at_ultrasound_guided_core_needle_biopsy_ L2 - https://doi.org/10.1007/s10549-007-9824-0 DB - PRIME DP - Unbound Medicine ER -