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Risk predictors of underestimation and the need for sentinel node biopsy in patients diagnosed with ductal carcinoma in situ by preoperative needle biopsy.
J Surg Oncol. 2013 Mar; 107(4):388-92.JS

Abstract

BACKGROUND

Diagnosis of ductal carcinoma in situ (DCIS) by core needle biopsy showed a high rate of underestimation of invasiveness, and performing sentinel lymph node biopsy (SLNB) in DCIS patients was controversial.

METHODS

We analyzed 340 DCIS patients who were diagnosed by needle biopsies. Final pathology and clinicopathological features were reviewed. Predictors were accessed using the Chi-square test and a binary logistic regression model.

RESULTS

The overall DCIS underestimation rate was 42.6%. The underestimation was significantly related to the palpability, mass or calcification by ultrasonography, grade, suspicious microinvasion, and biopsy method in univariate analysis. In multivariate analysis, palpability, ultrasonographic calcification or mass, suspicious microinvasion, and core needle biopsy were independent predictors of underestimation of invasive cancer. In cases with one or no risk predictors, the underestimation rate was 14.3%, whereas, in those with five predictors, it increased to 90.9%. Among 144 invasive cancer patients who underwent axillary staging, 15.4% had node metastasis.

CONCLUSIONS

DCIS diagnosed by preoperative needle biopsy has a high probability of underestimation, and 15% of invasive cancer patients have node metastasis. SLNB may be justified in DCIS patients undergoing needle biopsies, and caution should be exercised in omitting SLNB in patients with one or no risk predictors.

Authors+Show Affiliations

Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.No 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

23007901

Citation

Park, Hyung Seok, et al. "Risk Predictors of Underestimation and the Need for Sentinel Node Biopsy in Patients Diagnosed With Ductal Carcinoma in Situ By Preoperative Needle Biopsy." Journal of Surgical Oncology, vol. 107, no. 4, 2013, pp. 388-92.
Park HS, Park S, Cho J, et al. Risk predictors of underestimation and the need for sentinel node biopsy in patients diagnosed with ductal carcinoma in situ by preoperative needle biopsy. J Surg Oncol. 2013;107(4):388-92.
Park, H. S., Park, S., Cho, J., Park, J. M., Kim, S. I., & Park, B. W. (2013). Risk predictors of underestimation and the need for sentinel node biopsy in patients diagnosed with ductal carcinoma in situ by preoperative needle biopsy. Journal of Surgical Oncology, 107(4), 388-92. https://doi.org/10.1002/jso.23273
Park HS, et al. Risk Predictors of Underestimation and the Need for Sentinel Node Biopsy in Patients Diagnosed With Ductal Carcinoma in Situ By Preoperative Needle Biopsy. J Surg Oncol. 2013;107(4):388-92. PubMed PMID: 23007901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk predictors of underestimation and the need for sentinel node biopsy in patients diagnosed with ductal carcinoma in situ by preoperative needle biopsy. AU - Park,Hyung Seok, AU - Park,Seho, AU - Cho,Junghoon, AU - Park,Ji Min, AU - Kim,Seung Il, AU - Park,Byeong-Woo, Y1 - 2012/09/24/ PY - 2012/06/18/received PY - 2012/09/06/accepted PY - 2012/9/26/entrez PY - 2012/9/26/pubmed PY - 2013/4/6/medline SP - 388 EP - 92 JF - Journal of surgical oncology JO - J Surg Oncol VL - 107 IS - 4 N2 - BACKGROUND: Diagnosis of ductal carcinoma in situ (DCIS) by core needle biopsy showed a high rate of underestimation of invasiveness, and performing sentinel lymph node biopsy (SLNB) in DCIS patients was controversial. METHODS: We analyzed 340 DCIS patients who were diagnosed by needle biopsies. Final pathology and clinicopathological features were reviewed. Predictors were accessed using the Chi-square test and a binary logistic regression model. RESULTS: The overall DCIS underestimation rate was 42.6%. The underestimation was significantly related to the palpability, mass or calcification by ultrasonography, grade, suspicious microinvasion, and biopsy method in univariate analysis. In multivariate analysis, palpability, ultrasonographic calcification or mass, suspicious microinvasion, and core needle biopsy were independent predictors of underestimation of invasive cancer. In cases with one or no risk predictors, the underestimation rate was 14.3%, whereas, in those with five predictors, it increased to 90.9%. Among 144 invasive cancer patients who underwent axillary staging, 15.4% had node metastasis. CONCLUSIONS: DCIS diagnosed by preoperative needle biopsy has a high probability of underestimation, and 15% of invasive cancer patients have node metastasis. SLNB may be justified in DCIS patients undergoing needle biopsies, and caution should be exercised in omitting SLNB in patients with one or no risk predictors. SN - 1096-9098 UR - https://www.unboundmedicine.com/medline/citation/23007901/Risk_predictors_of_underestimation_and_the_need_for_sentinel_node_biopsy_in_patients_diagnosed_with_ductal_carcinoma_in_situ_by_preoperative_needle_biopsy_ L2 - https://doi.org/10.1002/jso.23273 DB - PRIME DP - Unbound Medicine ER -