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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

Authors
 Hyung Seok Park  ;  Seho Park  ;  JungHoon Cho  ;  Ji Min Park  ;  Seung Il Kim  ;  Byeong-Woo Park 
Citation
 Journal of Surgical Oncology, Vol.107(4) : 388-392, 2013 
Journal Title
 Journal of Surgical Oncology 
ISSN
 0022-4790 
Issue Date
2013
MeSH
Adult ; Aged ; Axilla ; Biomarkers, Tumor/analysis ; Biopsy, Large-Core Needle* ; Breast Neoplasms/diagnosis* ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Carcinoma, Intraductal, Noninfiltrating/diagnosis* ; Carcinoma, Intraductal, Noninfiltrating/pathology ; Carcinoma, Intraductal, Noninfiltrating/surgery ; Factor Analysis, Statistical ; Female ; Humans ; Logistic Models ; Lymph Nodes/pathology* ; Lymphatic Metastasis/diagnosis ; Mammography ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Staging ; Predictive Value of Tests ; Preoperative Period ; Risk Assessment ; Risk Factors ; Sentinel Lymph Node Biopsy* ; Ultrasonography, Mammary
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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jso.23273/abstract
DOI
10.1002/jso.23273
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김승일(Kim, Seung Il)
박병우(Park, Byeong Woo) ORCID logo https://orcid.org/0000-0003-1353-2607
박세호(Park, Se Ho) ORCID logo https://orcid.org/0000-0001-8089-2755
박지민(Park, Ji Min)
박형석(Park, Hyung Seok) ORCID logo https://orcid.org/0000-0001-5322-6036
조정훈(Cho, Jung Hoon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/158252
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