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Prediction of underestimated invasiveness in patients with ductal carcinoma in situ of the breast on percutaneous biopsy as rationale for recommending concurrent sentinel lymph node biopsy

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Prediction of underestimated invasiveness in patients with ductal carcinoma in situ of the breast on percutaneous biopsy as rationale for recommending concurrent sentinel lymph node biopsy. / Schulz, Sophie; Sinn, Peter; Golatta, Michael; Rauch, Geraldine; Junkermann, Hans; Schuetz, Florian; Sohn, Christof; Heil, Joerg.

In: BREAST, Vol. 22, No. 4, 08.2013, p. 537-542.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schulz, S, Sinn, P, Golatta, M, Rauch, G, Junkermann, H, Schuetz, F, Sohn, C & Heil, J 2013, 'Prediction of underestimated invasiveness in patients with ductal carcinoma in situ of the breast on percutaneous biopsy as rationale for recommending concurrent sentinel lymph node biopsy', BREAST, vol. 22, no. 4, pp. 537-542. https://doi.org/10.1016/j.breast.2012.11.002

APA

Schulz, S., Sinn, P., Golatta, M., Rauch, G., Junkermann, H., Schuetz, F., Sohn, C., & Heil, J. (2013). Prediction of underestimated invasiveness in patients with ductal carcinoma in situ of the breast on percutaneous biopsy as rationale for recommending concurrent sentinel lymph node biopsy. BREAST, 22(4), 537-542. https://doi.org/10.1016/j.breast.2012.11.002

Vancouver

Schulz S, Sinn P, Golatta M, Rauch G, Junkermann H, Schuetz F et al. Prediction of underestimated invasiveness in patients with ductal carcinoma in situ of the breast on percutaneous biopsy as rationale for recommending concurrent sentinel lymph node biopsy. BREAST. 2013 Aug;22(4):537-542. https://doi.org/10.1016/j.breast.2012.11.002

Bibtex

@article{952a0ce7d4d74b54b1e9b33c5099339b,
title = "Prediction of underestimated invasiveness in patients with ductal carcinoma in situ of the breast on percutaneous biopsy as rationale for recommending concurrent sentinel lymph node biopsy",
abstract = "AIM: To develop a model to predict invasion and improve the indication of concurrent sentinel lymph node biopsy (SLNB) for patients with ductal carcinoma in situ (DCIS) on minimally invasive biopsy.METHODS: We evaluated the data of 205 patients with DCIS in minimally invasive biopsy specimens. Clinical, radiological and histological variables were assessed in order to identify predictors of invasive carcinoma in final pathology using logistic regression analyses. We developed and retrospectively tested an algorithm to indicate concurrent SLNB.RESULTS: Invasiveness was underestimated in 18.0% (37 of 205). Univariate analysis revealed the following significant risk factors: lesion palpability, a mass lesion on ultrasound, the presence of a mammographically detectable mass, architectural distortion or density, a BI-RADS score of 5, a lesion diameter ≥50 mm, and ≥50% of histologically affected ducts. With a palpable mass, which remained the only independent predictor of invasion after multivariate adjustment, and the presence of at least three of the remaining five risk factors, the probability of invasion was 56.0%. If the prediction model had been used to indicate SLNB 9.8% (20 of 205) of patients could have been benefited (i.e. spared unnecessary or correctly recommended concurrent SLNB) compared to the factual performed SLNB procedures. Those patients with pure DCIS treated with breast conserving surgery (BCS) benefited most with a relative risk reduction of nearly 50% for unnecessary SLNB.CONCLUSION: The prediction model could rationally guide an informed discussion about risks and benefits of concurrent SLNB in patients with DCIS on minimally invasive biopsy.",
keywords = "Adult, Aged, Aged, 80 and over, Biopsy, Large-Core Needle, Breast Neoplasms, Carcinoma, Ductal, Breast, Carcinoma, Intraductal, Noninfiltrating, Cohort Studies, Diagnostic Errors, Female, Humans, Logistic Models, Mammography, Mastectomy, Segmental, Middle Aged, Neoplasm Invasiveness, Retrospective Studies, Risk Factors, Sentinel Lymph Node Biopsy, Journal Article",
author = "Sophie Schulz and Peter Sinn and Michael Golatta and Geraldine Rauch and Hans Junkermann and Florian Schuetz and Christof Sohn and Joerg Heil",
note = "Copyright {\textcopyright} 2012 Elsevier Ltd. All rights reserved.",
year = "2013",
month = aug,
doi = "10.1016/j.breast.2012.11.002",
language = "English",
volume = "22",
pages = "537--542",
journal = "BREAST",
issn = "0960-9776",
publisher = "Churchill Livingstone",
number = "4",

}

RIS

TY - JOUR

T1 - Prediction of underestimated invasiveness in patients with ductal carcinoma in situ of the breast on percutaneous biopsy as rationale for recommending concurrent sentinel lymph node biopsy

AU - Schulz, Sophie

AU - Sinn, Peter

AU - Golatta, Michael

AU - Rauch, Geraldine

AU - Junkermann, Hans

AU - Schuetz, Florian

AU - Sohn, Christof

AU - Heil, Joerg

N1 - Copyright © 2012 Elsevier Ltd. All rights reserved.

PY - 2013/8

Y1 - 2013/8

N2 - AIM: To develop a model to predict invasion and improve the indication of concurrent sentinel lymph node biopsy (SLNB) for patients with ductal carcinoma in situ (DCIS) on minimally invasive biopsy.METHODS: We evaluated the data of 205 patients with DCIS in minimally invasive biopsy specimens. Clinical, radiological and histological variables were assessed in order to identify predictors of invasive carcinoma in final pathology using logistic regression analyses. We developed and retrospectively tested an algorithm to indicate concurrent SLNB.RESULTS: Invasiveness was underestimated in 18.0% (37 of 205). Univariate analysis revealed the following significant risk factors: lesion palpability, a mass lesion on ultrasound, the presence of a mammographically detectable mass, architectural distortion or density, a BI-RADS score of 5, a lesion diameter ≥50 mm, and ≥50% of histologically affected ducts. With a palpable mass, which remained the only independent predictor of invasion after multivariate adjustment, and the presence of at least three of the remaining five risk factors, the probability of invasion was 56.0%. If the prediction model had been used to indicate SLNB 9.8% (20 of 205) of patients could have been benefited (i.e. spared unnecessary or correctly recommended concurrent SLNB) compared to the factual performed SLNB procedures. Those patients with pure DCIS treated with breast conserving surgery (BCS) benefited most with a relative risk reduction of nearly 50% for unnecessary SLNB.CONCLUSION: The prediction model could rationally guide an informed discussion about risks and benefits of concurrent SLNB in patients with DCIS on minimally invasive biopsy.

AB - AIM: To develop a model to predict invasion and improve the indication of concurrent sentinel lymph node biopsy (SLNB) for patients with ductal carcinoma in situ (DCIS) on minimally invasive biopsy.METHODS: We evaluated the data of 205 patients with DCIS in minimally invasive biopsy specimens. Clinical, radiological and histological variables were assessed in order to identify predictors of invasive carcinoma in final pathology using logistic regression analyses. We developed and retrospectively tested an algorithm to indicate concurrent SLNB.RESULTS: Invasiveness was underestimated in 18.0% (37 of 205). Univariate analysis revealed the following significant risk factors: lesion palpability, a mass lesion on ultrasound, the presence of a mammographically detectable mass, architectural distortion or density, a BI-RADS score of 5, a lesion diameter ≥50 mm, and ≥50% of histologically affected ducts. With a palpable mass, which remained the only independent predictor of invasion after multivariate adjustment, and the presence of at least three of the remaining five risk factors, the probability of invasion was 56.0%. If the prediction model had been used to indicate SLNB 9.8% (20 of 205) of patients could have been benefited (i.e. spared unnecessary or correctly recommended concurrent SLNB) compared to the factual performed SLNB procedures. Those patients with pure DCIS treated with breast conserving surgery (BCS) benefited most with a relative risk reduction of nearly 50% for unnecessary SLNB.CONCLUSION: The prediction model could rationally guide an informed discussion about risks and benefits of concurrent SLNB in patients with DCIS on minimally invasive biopsy.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biopsy, Large-Core Needle

KW - Breast Neoplasms

KW - Carcinoma, Ductal, Breast

KW - Carcinoma, Intraductal, Noninfiltrating

KW - Cohort Studies

KW - Diagnostic Errors

KW - Female

KW - Humans

KW - Logistic Models

KW - Mammography

KW - Mastectomy, Segmental

KW - Middle Aged

KW - Neoplasm Invasiveness

KW - Retrospective Studies

KW - Risk Factors

KW - Sentinel Lymph Node Biopsy

KW - Journal Article

U2 - 10.1016/j.breast.2012.11.002

DO - 10.1016/j.breast.2012.11.002

M3 - SCORING: Journal article

C2 - 23237921

VL - 22

SP - 537

EP - 542

JO - BREAST

JF - BREAST

SN - 0960-9776

IS - 4

ER -