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A nomogram for predicting underestimation of invasiveness in ductal carcinoma in situ diagnosed by preoperative needle biopsy

 Hyung Seok Park  ;  Ha Yan Kim  ;  Seho Park  ;  Eun-Kyung Kim  ;  Seung Il Kim  ;  Byeong-Woo Park 
 BREAST, Vol.22(5) : 869-873, 2013 
Journal Title
Issue Date
Area Under Curve ; Biopsy, Large-Core Needle* ; Breast Neoplasms/pathology* ; Carcinoma, Intraductal, Noninfiltrating/pathology* ; Female ; Humans ; Neoplasm Invasiveness ; Nomograms* ; Probability ; ROC Curve ; Risk Factors
Axillary metastasis ; Mammary ultrasonography ; Mammography ; Needle biopsy ; Nomogram ; Noninfiltrating intraductal carcinoma
It is unnecessary to perform axillary staging in patients with ductal carcinoma in situ (DCIS) of the breast because of the low incidence of axillary metastasis. However, diagnosis of DCIS by core needle biopsy showed a high rate of underestimation of invasive cancer. Thus, it is necessary to predict invasiveness in DCIS patients on core before surgery. We analyzed 340 patients with DCIS diagnosed by needle biopsy. The cases were divided into training and validation sets. Logistic regression was performed to predict the presence of invasive cancer in the final pathology, and a nomogram was constructed from the training set using the presence of palpability, the presence of ultrasonographic calcification and mass, the biopsy tools, and the presence of microinvasion. The model was subsequently applied to the validation set. The nomogram for the training set was both accurate and discriminating, with an area under the receiver operating characteristic curve (AUC) of 0.75. When applied to the validation group, the model accurately predicted the likelihood of invasive cancer (AUC: 0.71). Our nomogram will allow surgeons to easily and accurately estimate the likelihood of invasive cancer in patients with DCIS as diagnosed by preoperative needle biopsy.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Seung Il(김승일)
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Kim, Ha Yan(김하얀)
Park, Byeong Woo(박병우) ORCID logo https://orcid.org/0000-0003-1353-2607
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Park, Hyung Seok(박형석) ORCID logo https://orcid.org/0000-0001-5322-6036
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