Risk predictors of underestimation and the need for sentinel node biopsy in patients diagnosed with ductal carcinoma in situ by preoperative needle biopsy

Hyung Seok Park, Seho Park, Junghoon Cho, Ji Min Park, Seung Il Kim, Byeong Woo Park

Research output: Contribution to journalArticle

36 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)388-392
Number of pages5
JournalJournal of surgical oncology
Volume107
Issue number4
DOIs
Publication statusPublished - 2013 Mar 1

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Carcinoma, Intraductal, Noninfiltrating
Needle Biopsy
Biopsy
Sentinel Lymph Node Biopsy
Large-Core Needle Biopsy
Logistic Models
Neoplasm Metastasis
Neoplasms
Chi-Square Distribution
cyhalothrin
Ultrasonography
Multivariate Analysis
Pathology

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

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title = "Risk predictors of underestimation and the need for sentinel node biopsy in patients diagnosed with ductal carcinoma in situ by preoperative needle biopsy",
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.",
author = "Park, {Hyung Seok} and Seho Park and Junghoon Cho and Park, {Ji Min} and Kim, {Seung Il} and Park, {Byeong Woo}",
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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. / Park, Hyung Seok; Park, Seho; Cho, Junghoon; Park, Ji Min; Kim, Seung Il; Park, Byeong Woo.

In: Journal of surgical oncology, Vol. 107, No. 4, 01.03.2013, p. 388-392.

Research output: Contribution to journalArticle

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AU - Park, Seho

AU - Cho, Junghoon

AU - Park, Ji Min

AU - Kim, Seung Il

AU - Park, Byeong Woo

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N2 - 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.

AB - 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.

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