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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.identifier.citationCLINICAL BREAST CANCER, v.18, n.5, p.E805-E812, 2018
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.publisherCIG MEDIA GROUP, LP
dc.relation.ispartofClinical Breast Cancer
dc.subjectBreast neoplasm
dc.subjectIntraductal carcinoma
dc.subjectSentinel lymph node biopsy
dc.subject.otherlymph-node biopsy
dc.subject.otherprimary tumor characteristics
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.rights.holderCopyright CIG MEDIA GROUP, LP
dc.type.categoryoriginal article
dc.type.versionpublishedVersion, 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.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
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Artigos e Materiais de Revistas Científicas - FM/MDR
Departamento de Radiologia - FM/MDR

Artigos e Materiais de Revistas Científicas - FM/MOG
Departamento de Obstetrícia e Ginecologia - FM/MOG

Artigos e Materiais de Revistas Científicas - FM/MPT
Departamento de Patologia - FM/MPT

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InRad
Instituto de Radiologia - HC/InRad

Artigos e Materiais de Revistas Científicas - LIM/01
LIM/01 - Laboratório de Informática Médica

Artigos e Materiais de Revistas Científicas - LIM/44
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia

Artigos e Materiais de Revistas Científicas - LIM/58
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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