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An Updated Nomogram for Predicting Invasiveness in Preoperative Ductal Carcinoma In Situ of the Breast

PURPOSE: To validate and update a nomogram for predicting ductal carcinoma in situ (DCIS) upstaging in preoperative biopsy. MATERIALS AND METHODS: Medical records of 444 preoperative DCIS patients were evaluated and used to validate a previous version of the Severance nomogram for predicting DCIS up...

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Autores principales: Kim, Sanghwa, Kim, Jihong, Park, Hyung Seok, Kim, Ha Yan, Lee, Kwanbum, Lee, Jeea, Lee, Haemin, Kim, Jee Ye, Kim, Seung Il, Cho, Young Up, Park, Byeong-Woo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813145/
https://www.ncbi.nlm.nih.gov/pubmed/31637884
http://dx.doi.org/10.3349/ymj.2019.60.11.1028
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author Kim, Sanghwa
Kim, Jihong
Park, Hyung Seok
Kim, Ha Yan
Lee, Kwanbum
Lee, Jeea
Lee, Haemin
Kim, Jee Ye
Kim, Seung Il
Cho, Young Up
Park, Byeong-Woo
author_facet Kim, Sanghwa
Kim, Jihong
Park, Hyung Seok
Kim, Ha Yan
Lee, Kwanbum
Lee, Jeea
Lee, Haemin
Kim, Jee Ye
Kim, Seung Il
Cho, Young Up
Park, Byeong-Woo
author_sort Kim, Sanghwa
collection PubMed
description PURPOSE: To validate and update a nomogram for predicting ductal carcinoma in situ (DCIS) upstaging in preoperative biopsy. MATERIALS AND METHODS: Medical records of 444 preoperative DCIS patients were evaluated and used to validate a previous version of the Severance nomogram for predicting DCIS upstaging in preoperative biopsy. Patients were divided into two groups according to the final postoperative pathology. Univariate and multivariate analyses with the chi-square test, Student's t-test, and binary logistic regression method identified new significant variables. The updated nomogram was evaluated with the C-index and Hosmer—Lemeshow goodness of fit test. RESULTS: The area under a receiver operating characteristic curve for comparison with the previous nomogram was 0.48. In postoperative pathology, the pure DCIS and invasive cancer groups comprised 345 and 99 cases, respectively. Approximately 22.3% of patients preoperatively diagnosed with DCIS were upstaged to invasive cancer. Significant variables in the univariate analysis were operation type, human epidermal growth factor receptor 2 overexpression, comedo necrosis, sonographic mass, mammographic mass, preoperative biopsy method, and suspicious microinvasion in preoperative biopsy. In multivariate analysis, operation type, sonographic mass, mammographic mass, and suspicious microinvasion were risk factors for upstaging. The updated model with these variables showed moderate discrimination and was appropriate in the calibration test. CONCLUSION: The previous nomogram did not effectively discriminate upstaging of preoperative DCIS in an independent cohort. An updated version of the nomogram appears to provide more accurate information for predicting preoperative DCIS upstaging.
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spelling pubmed-68131452019-11-01 An Updated Nomogram for Predicting Invasiveness in Preoperative Ductal Carcinoma In Situ of the Breast Kim, Sanghwa Kim, Jihong Park, Hyung Seok Kim, Ha Yan Lee, Kwanbum Lee, Jeea Lee, Haemin Kim, Jee Ye Kim, Seung Il Cho, Young Up Park, Byeong-Woo Yonsei Med J Original Article PURPOSE: To validate and update a nomogram for predicting ductal carcinoma in situ (DCIS) upstaging in preoperative biopsy. MATERIALS AND METHODS: Medical records of 444 preoperative DCIS patients were evaluated and used to validate a previous version of the Severance nomogram for predicting DCIS upstaging in preoperative biopsy. Patients were divided into two groups according to the final postoperative pathology. Univariate and multivariate analyses with the chi-square test, Student's t-test, and binary logistic regression method identified new significant variables. The updated nomogram was evaluated with the C-index and Hosmer—Lemeshow goodness of fit test. RESULTS: The area under a receiver operating characteristic curve for comparison with the previous nomogram was 0.48. In postoperative pathology, the pure DCIS and invasive cancer groups comprised 345 and 99 cases, respectively. Approximately 22.3% of patients preoperatively diagnosed with DCIS were upstaged to invasive cancer. Significant variables in the univariate analysis were operation type, human epidermal growth factor receptor 2 overexpression, comedo necrosis, sonographic mass, mammographic mass, preoperative biopsy method, and suspicious microinvasion in preoperative biopsy. In multivariate analysis, operation type, sonographic mass, mammographic mass, and suspicious microinvasion were risk factors for upstaging. The updated model with these variables showed moderate discrimination and was appropriate in the calibration test. CONCLUSION: The previous nomogram did not effectively discriminate upstaging of preoperative DCIS in an independent cohort. An updated version of the nomogram appears to provide more accurate information for predicting preoperative DCIS upstaging. Yonsei University College of Medicine 2019-11-01 2019-10-17 /pmc/articles/PMC6813145/ /pubmed/31637884 http://dx.doi.org/10.3349/ymj.2019.60.11.1028 Text en © Copyright: Yonsei University College of Medicine 2019 https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Sanghwa
Kim, Jihong
Park, Hyung Seok
Kim, Ha Yan
Lee, Kwanbum
Lee, Jeea
Lee, Haemin
Kim, Jee Ye
Kim, Seung Il
Cho, Young Up
Park, Byeong-Woo
An Updated Nomogram for Predicting Invasiveness in Preoperative Ductal Carcinoma In Situ of the Breast
title An Updated Nomogram for Predicting Invasiveness in Preoperative Ductal Carcinoma In Situ of the Breast
title_full An Updated Nomogram for Predicting Invasiveness in Preoperative Ductal Carcinoma In Situ of the Breast
title_fullStr An Updated Nomogram for Predicting Invasiveness in Preoperative Ductal Carcinoma In Situ of the Breast
title_full_unstemmed An Updated Nomogram for Predicting Invasiveness in Preoperative Ductal Carcinoma In Situ of the Breast
title_short An Updated Nomogram for Predicting Invasiveness in Preoperative Ductal Carcinoma In Situ of the Breast
title_sort updated nomogram for predicting invasiveness in preoperative ductal carcinoma in situ of the breast
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813145/
https://www.ncbi.nlm.nih.gov/pubmed/31637884
http://dx.doi.org/10.3349/ymj.2019.60.11.1028
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