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Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy to invasive cancer in subsequent surgical excision.
Breast. 2012 Oct; 21(5):641-5.B

Abstract

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.

Authors+Show Affiliations

Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of 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 available

Pub Type(s)

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

Language

eng

PubMed ID

22749854

Citation

Kim, Jisun, et al. "Factors Associated With Upstaging From Ductal Carcinoma in Situ Following Core Needle Biopsy to Invasive Cancer in Subsequent Surgical Excision." Breast (Edinburgh, Scotland), vol. 21, no. 5, 2012, pp. 641-5.
Kim J, Han W, Lee JW, et al. Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy to invasive cancer in subsequent surgical excision. Breast. 2012;21(5):641-5.
Kim, J., Han, W., Lee, J. W., You, J. M., Shin, H. C., Ahn, S. K., Moon, H. G., Cho, N., Moon, W. K., Park, I. A., & Noh, D. Y. (2012). Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy to invasive cancer in subsequent surgical excision. Breast (Edinburgh, Scotland), 21(5), 641-5. https://doi.org/10.1016/j.breast.2012.06.012
Kim J, et al. Factors Associated With Upstaging From Ductal Carcinoma in Situ Following Core Needle Biopsy to Invasive Cancer in Subsequent Surgical Excision. Breast. 2012;21(5):641-5. PubMed PMID: 22749854.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy to invasive cancer in subsequent surgical excision. AU - Kim,Jisun, AU - Han,Wonshik, AU - Lee,Jong Won, AU - You,Jee-Man, AU - Shin,Hee-Chul, AU - Ahn,Soo Kyung, AU - Moon,Hyeong-Gon, AU - Cho,Nariya, AU - Moon,Woo Kyung, AU - Park,In-Ae, AU - Noh,Dong-Young, Y1 - 2012/06/30/ PY - 2011/12/20/received PY - 2012/04/09/revised PY - 2012/06/20/accepted PY - 2012/7/4/entrez PY - 2012/7/4/pubmed PY - 2013/1/30/medline SP - 641 EP - 5 JF - Breast (Edinburgh, Scotland) JO - Breast VL - 21 IS - 5 N2 - 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. SN - 1532-3080 UR - https://www.unboundmedicine.com/medline/citation/22749854/Factors_associated_with_upstaging_from_ductal_carcinoma_in_situ_following_core_needle_biopsy_to_invasive_cancer_in_subsequent_surgical_excision_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0960-9776(12)00130-0 DB - PRIME DP - Unbound Medicine ER -