The preoperative factors associated with underestimation of invasive breast cancer in stereotactic vacuum-assisted biopsy-diagnosed DCIS patients

Authors

  • Somchanin Pipatpajong, M.D. Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
  • Rachata Tangkulboriboon, M.D. Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.

DOI:

https://doi.org/10.46475/asean-jr.v24i2.778

Keywords:

Breast cancer, Ductal carcinoma in situ, Underestimation, Stereotactic vacuum-assisted biopsy

Abstract

Objective: To determine preoperative factors associated with underestimation of invasive breast cancer, where stereotactic vacuum-assisted biopsy (VAB) diagnosed as ductal carcinoma in situ (DCIS).

Materials and Methods: Data from 95 patients diagnosed with DCIS by stereotactic VAB, including their clinical, radiological, and pathological findings between November 2010 and May 2021, were analyzed retrospectively. The clinical, radiological, and pathological features were analyzed.

Results: The underestimation rate was 30.5 %. Three preoperative features were significantly associated with the underestimation of invasive breast cancer in multivariable analysis, including palpability (OR, 11.51; 95% CI: 1.817-72.897; P = 0.009), BI-RADS category (OR, 3.705; 95% CI: 1.214-11.303; P = 0.021), and visibility of a mammographically detected lesion at ultrasonography (OR, 7.115; 95% CI: 1.977-25.611; P = 0.003). The calcification morphology was statistically significant in an univariable analysis but not in a multivariable analysis.

Conclusion: Preoperative variables significantly associated with underdiagnosis of invasive breast cancer, including palpability, BI-RADS category, and visibility of mammographically detected lesions at ultrasonography, could aid in assessing the risk of developing invasive breast cancer and conducting treatment selection.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Parikh U, Chhor CM, Mercado CL. Ductal carcinoma in situ: the whole truth. AJR Am J Roentgenol 2018;210:246-55. doi: 10.2214/AJR.17.18778.

NCCN Clinical Practice Guidelines in Oncology: Breast Cancer (Version 3.2019) [Internet].NCCN;2019 Sept 6 [cited 2023 Jul 2]. Available from: https://www2.tri-kobe.org/nccn/guideline/archive/breast2019/english/breast_v3.pdf

Brennan ME, Turner RM, Ciatto S, Marinovich ML, French JR, Macaskill P, et al. Ductal carcinoma in situ at core-needle biopsy: meta-analysis of underestimation andpredictors of invasive breast cancer. Radiology 2011;260:119-28. doi: 10.1148/radiol.11102368.

Kim J, Han W, Lee JW, You JM, Shin HC, Ahn SK, et al. Factors associated with upstaging from ductal carcinoma in situ following core needle biopsy to invasive cancer in subsequent surgical excision. Breast 2012 ;21:641-5 . doi: 10.1016/j.breast.2012.06.012.

Meurs CJC, van Rosmalen J, Menke-Pluijmers MBE, Ter Braak BPM, de Munck L, et al. A prediction model for underestimation of invasive breast cancer after a biopsy diagnosis of ductal carcinoma in situ: based on 2892 biopsies and 589 invasive cancers. Br J Cancer 2018;119:1155-62. doi: 10.1038/s41416-018-0276-6.

Jakub JW, Murphy BL, Gonzalez AB, Conners AL, Henrichsen TL, Maimone S 4th, et al. A validated nomogram to predict upstaging of ductal carcinoma in situ to invasive disease. Ann Surg Oncol 2017;24:2915-24. doi: 10.1245/s10434-017-5927-y.

Chan MY, Lim S. Predictors of invasive breast cancer in ductal carcinoma in situ initially diagnosed by core biopsy. Asian J Surg 2010;33:76-82. doi: 10.1016/S1015-9584(10)60013-9.

Esen G, Tutar B, Uras C, Calay Z, İnce Ü, Tutar O. Vacuum-assisted stereotactic breast biopsy in the diagnosis and management of suspicious microcalcifications. Diagn Interv Radiol 2016;22:326-33. doi: 10.5152/dir.2015.14522.

Luparia A, Durando M, Campanino P, Regini E, Lucarelli D, Talenti A, et al. Efficacy and cost-effectiveness of stereotactic vacuum-assisted core biopsy of nonpalpable breast lesions: analysis of 602 biopsies performed over 5 years. Radiol Med 2011;116:477-88. English, Italian. doi: 10.1007/s11547-011-0625-x.

Jackman RJ, Burbank F, Parker SH, Evans WP 3rd, Lechner MC, Richardson TR,et al. Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates. Radiology 2001;218:497-502. doi: 10.1148/radiology.218.2.r01fe35497.

Pandelidis S, Heilman D, Jones D, Stough K, Trapeni J, Suliman Y. Accuracy of 11-gauge vacuum-assisted core biopsy of mammographic breast lesions. Ann Surg Oncol 2003;10:43-7. doi: 10.1245/aso.2003.05.004.

Kettritz U, Rotter K, Schreer I, Murauer M, Schulz‐Wendtland R, Peter D, et al. Stereotactic vacuum‐assisted breast biopsy in 2874 patients: a multicenter study. Cancer 2004;100:245-51. doi: 10.1002/cncr.11887.

Lee CH, Carter D, Philpotts LE, Couce ME, Horvath LJ, Lange RC, et al. Ductal carcinoma in situ diagnosed with stereotactic core needle biopsy: can invasion be predicted?. Radiology 2000;217:466-70. doi: 10.1148/radiology.217.2.r00nv08466.

Kim M, Kim HJ, Chung YR, Kang E, Kim EK, Kim SH, et al. Microinvasive carcinoma versus ductal carcinoma in situ: a comparison of clinicopathological features and clinical outcomes. J Breast Cancer 2018;21:197-205. doi: 10.4048/jbc.2018.21.2.197.

Houssami N, Ciatto S, Ellis I, Ambrogetti D. Underestimation of malignancy of breast core-needle biopsy: concepts and precise overall and category-specific estimates. Cancer 2007;109:487-95. doi: 10.1002/cncr.22435.

Jiang L, Ma T, Moran MS, Kong X, Li X, Haffty BG, et al. Mammographic features are associated with clinicopathological characteristics in invasive breast cancer. Anticancer Res 2011;31:2327-34.

Wadhwa A, Majidi SS, Cherian S, Dykstra DS, Deitch SG, Hansen C, et al. Architectural Distortion on Screening Digital Breast Tomosynthesis: Pathologic Outcomes and Indicators of Malignancy. J Breast Imaging 2021;3:34-43.

Downloads

Published

2023-08-31

How to Cite

1.
Pipatpajong S, Tangkulboriboon R. The preoperative factors associated with underestimation of invasive breast cancer in stereotactic vacuum-assisted biopsy-diagnosed DCIS patients . ASEAN J Radiol [Internet]. 2023 Aug. 31 [cited 2024 Jul. 22];24(2):80-97. Available from: https://asean-journal-radiology.org/index.php/ajr/article/view/778

Issue

Section

Original Article

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.