Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/29594
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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorDARIA, Maira Teixeira
dc.contributor.authorMAESAKA, Jonathan Yugo
dc.contributor.authorAZEVEDO NETO, Raymundo Soares de
dc.contributor.authorBARROS, Nestor de
dc.contributor.authorBARACAT, Edmund Chada
dc.contributor.authorFILASSI, Jose Roberto
dc.date.accessioned2018-11-21T17:06:25Z
dc.date.available2018-11-21T17:06:25Z
dc.date.issued2018
dc.identifier.citationCLINICAL BREAST CANCER, v.18, n.5, p.E805-E812, 2018
dc.identifier.issn1526-8209
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/29594
dc.description.abstractOur aim was to develop a model to predict invasiveness in patients with a diagnosis of ductal carcinoma in situ found at percutaneous biopsy. The calculated sample size was 296 patients. We used Nagelkerke's R-2 and Hosmer-Lemeshow goodness-of-fit tests to improve statistical analysis. We evaluated 354 patients and developed 2 models that have the best discrimination reported to date. Background: Approximately 30% of ductal carcinoma in situ (DCIS) cases have an invasive component discovered on the final analysis that could affect surgical management. The aims of the present study were to determine the risk factors associated with the underestimation of DCIS and to develop a model to predict the probability of invasiveness. Materials and Methods: A retrospective analysis was performed on the data for all patients with a diagnosis of DCIS found by percutaneous biopsy from January 2008 to February 2016. Thirteen potential predictors of invasiveness were examined. The statistical analysis of the present study was improved using Nagelkerke's R-2, the area under the receiving operating characteristic (AUC) curve, and the Hosmer-Lemeshow goodness-of-fit test. Results: Of 354 biopsy specimens deemed to be DCIS on initial biopsy, 100 (28.2%) were recategorized as invasive carcinoma after surgery. On multivariate analysis, the strongest predictors of invasiveness were comedonecrosis, size on mammography, suspected microinvasion, histologic grade, and younger patient age. The model had a good discriminative ability, with an AUC of 0.764. The overall performance of the model was fair, with a Nagelkerke's R-2 of 40.9%. A separate analysis performed on 274 specimens obtained through vacuum-assisted biopsy revealed different variables were associated with underestimation; however, a similar AUC (0.743) and Nagelkerke's R-2 (45.7% ) were obtained. Conclusion: Our model had the best AUC for predicting DCIS invasiveness reported to date. However, further statistical analysis showed only a fair overall performance. The currently known clinical, radiographic, and pathologic features might be insufficient to identify which patients with DCIS have underestimated disease.
dc.language.isoeng
dc.publisherCIG MEDIA GROUP, LP
dc.relation.ispartofClinical Breast Cancer
dc.rightsrestrictedAccess
dc.subjectBreast neoplasm
dc.subjectDCIS
dc.subjectIntraductal carcinoma
dc.subjectInvasive
dc.subjectSentinel lymph node biopsy
dc.subject.otherlymph-node biopsy
dc.subject.othercore-needle-biopsy
dc.subject.otherprimary tumor characteristics
dc.subject.otherbreast-cancer
dc.subject.otherrisk-factors
dc.subject.otherunderestimation
dc.subject.othermicrocalcifications
dc.subject.othermetaanalysis
dc.subject.othermammography
dc.subject.othermetastasis
dc.titleDevelopment of a Model to Predict Invasiveness in Ductal Carcinoma In Situ Diagnosed by Percutaneous Biopsy-Original Study and Critical Evaluation of the Literature
dc.typearticle
dc.rights.holderCopyright CIG MEDIA GROUP, LP
dc.identifier.doi10.1016/j.clbc.2018.04.011
dc.identifier.pmid29798815
dc.subject.wosOncology
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
hcfmusp.author.externalDARIA, Maira Teixeira:Univ Sao Paulo, Fac Med, Dept Obstet & Gynecol, Ave Dr Eneas Carvalho de Aguiar,255-10 Andar ICHC, BR-05403000 Sao Paulo, SP, Brazil
hcfmusp.description.beginpageE805
hcfmusp.description.endpageE812
hcfmusp.description.issue5
hcfmusp.description.volume18
hcfmusp.origemWOS
hcfmusp.origem.idWOS:000445702400013
hcfmusp.origem.id2-s2.0-85047094422
hcfmusp.publisher.cityDALLAS
hcfmusp.publisher.countryUSA
hcfmusp.relation.referenceAnsari B, 2008, BRIT J SURG, V95, P547, DOI 10.1002/bjs.6162
hcfmusp.relation.referenceBonnett M, 2002, MODERN PATHOL, V15, P95, DOI 10.1038/modpathol.3880497
hcfmusp.relation.referenceBrennan ME, 2011, RADIOLOGY, V260, P119, DOI 10.1148/radiol.11102368
hcfmusp.relation.referenceCoufal O, 2014, BIOMED RES INT, DOI 10.1155/2014/480840
hcfmusp.relation.referenceDiepstraten SCE, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0077826
hcfmusp.relation.referenceDoebar SC, 2016, BREAST, V27, P15, DOI 10.1016/j.breast.2016.02.014
hcfmusp.relation.referenceDoyle B, 2009, J CLIN PATHOL, V62, P534, DOI 10.1136/jcp.2008.061457
hcfmusp.relation.referenceELSTON CW, 1991, HISTOPATHOLOGY, V19, P403, DOI 10.1111/j.1365-2559.1991.tb00229.x
hcfmusp.relation.referenceEstevez LG, 2010, CANCER TREAT REV, V36, P507, DOI 10.1016/j.ctrv.2010.03.007
hcfmusp.relation.referenceGoyal A, 2006, BREAST CANCER RES TR, V98, P311, DOI 10.1007/s10549-006-9167-2
hcfmusp.relation.referenceHoussami N, 2011, ANN SURG ONCOL, V18, P1364, DOI 10.1245/s10434-010-1438-9
hcfmusp.relation.referenceIntra M, 2003, ARCH SURG-CHICAGO, V138, P309, DOI 10.1001/archsurg.138.3.309
hcfmusp.relation.referenceJackman RJ, 2001, RADIOLOGY, V218, P497, DOI 10.1148/radiology.218.2.r01fe35497
hcfmusp.relation.referenceKlauber-DeMore N, 2000, ANN SURG ONCOL, V7, P636, DOI 10.1007/s10434-000-0636-2
hcfmusp.relation.referenceKondo T, 2015, J SURG ONCOL, V112, P476, DOI 10.1002/jso.24037
hcfmusp.relation.referenceKrag DN, 2007, LANCET ONCOL, V8, P881, DOI 10.1016/S1470-2045(07)70278-4
hcfmusp.relation.referenceKurniawan ED, 2010, ARCH SURG-CHICAGO, V145, P1098, DOI 10.1001/archsurg.2010.243
hcfmusp.relation.referenceLakhani S. R., 2012, WHO CLASSIFICATION T
hcfmusp.relation.referenceLee JW, 2008, J SURG ONCOL, V98, P15, DOI 10.1002/jso.21077
hcfmusp.relation.referenceLester SC, 2009, ARCH PATHOL LAB MED, V133, P15, DOI 10.1043/1543-2165-133.1.15
hcfmusp.relation.referenceLyman GH, 2005, J CLIN ONCOL, V23, P7703, DOI 10.1200/JCO.2005.08.001
hcfmusp.relation.referenceMeijnen P, 2007, BRIT J SURG, V94, P952, DOI 10.1002/bjs.5735
hcfmusp.relation.referenceMittendorf Elizabeth A, 2005, Curr Surg, V62, P253
hcfmusp.relation.referenceMiyake T, 2011, AM J SURG, V202, P59, DOI 10.1016/j.amjsurg.2010.09.032
hcfmusp.relation.referenceNishimura Seiichiro, 2004, Breast Cancer, V11, P49, DOI 10.1007/BF02968002
hcfmusp.relation.referenceO'Flynn EAM, 2009, CLIN RADIOL, V64, P178, DOI 10.1016/j.crad.2008.08.007
hcfmusp.relation.referencePark HS, 2013, BREAST, V22, P869, DOI 10.1016/j.breast.2013.03.009
hcfmusp.relation.referencePark HS, 2013, J SURG ONCOL, V107, P388, DOI 10.1002/jso.23273
hcfmusp.relation.referenceRutstein LA, 2007, BREAST J, V13, P251, DOI 10.1111/j.1524-4741.2007.00418.x
hcfmusp.relation.referenceSchulz S, 2013, BREAST, V22, P537, DOI 10.1016/j.breast.2012.11.002
hcfmusp.relation.referenceShin HJ, 2010, AM J ROENTGENOL, V195, P1466, DOI 10.2214/AJR.10.4316
hcfmusp.relation.referenceSickles EA, 2013, ACR BI RADS ATLAS BR
hcfmusp.relation.referenceSILVERSTEIN MJ, 1994, CANCER-AM CANCER SOC, V73, P664, DOI 10.1002/1097-0142(19940201)73:3<664::AID-CNCR2820730326>3.0.CO;2-S
hcfmusp.relation.referenceSon BK, 2011, J BREAST CANCER, V14, P301, DOI 10.4048/jbc.2011.14.4.301
hcfmusp.relation.referenceSuh YJ, 2012, BRIT J RADIOL, V85, pE349, DOI 10.1259/bjr/30974918
hcfmusp.relation.referenceTrentin C, 2012, BREAST, V21, P635, DOI 10.1016/j.breast.2012.06.009
hcfmusp.relation.referenceUematsu T, 2008, BREAST CANCER-TOKYO, V15, P291, DOI 10.1007/s12282-008-0033-4
hcfmusp.relation.referenceWilkie C, 2005, AM J SURG, V190, P563, DOI 10.1016/j.amjsurg.2005.06.011
hcfmusp.relation.referenceYen TWF, 2005, J AM COLL SURGEONS, V200, P516, DOI 10.1016/j.jamcollsurg.2004.11.012
hcfmusp.relation.referenceYi M, 2008, AM J SURG, V196, P81, DOI 10.1016/j.amjsurg.2007.08.057
hcfmusp.relation.referenceYiangou C, 1999, BRIT J CANCER, V80, P1974, DOI 10.1038/sj.bjc.6690629
hcfmusp.relation.referenceZetterlund L, 2014, BRIT J SURG, V101, P488, DOI 10.1002/bjs.9404
dc.description.indexMEDLINE
dc.identifier.eissn1938-0666
hcfmusp.citation.scopus14
hcfmusp.scopus.lastupdate2022-08-25-
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