- 作者：Jisun Kim ; Wonshik Han ; Jong Won Lee ; Jee-Man You ; Hee-Chul Shin ; Soo Kyung Ahn ; Hyeong-Gon Moon ; Nariya Cho ; Woo Kyung Moon ; In-ae Park ; Dong-Young Noh
- 关键词：Breast cancer ; Ductal carcinoma in situ ; Underestimation ; Core needle biopsy
- 刊名：The Breast
- 出版年：2012
- 出版时间：October, 2012
- 年：2012
- 卷：21
- 期：5
- 页码：641-645
- 全文大小：159 K
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 ¡Ü20?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.