Sonographic lesion size of ductal carcinoma in situ as a preoperative predictor for the presence of an invasive focus.
OBJECTIVE
To investigate the preoperative factors associated with upstage to invasive cancer in patients with core needle biopsy (CNB) diagnosis of ductal carcinoma in situ (DCIS) by ultrasound guidance alone.


METHODS
Between 2000 and 2007, 201 patients with DCIS diagnosed at 11- or 14-gauge CNB by ultrasound guidance alone were examined. Preoperative factors were all analyzed to correlate with the presence of invasive cancer after definitive resection. The Pearson chi-square test and stratified analysis with the Mantel-Haenszel chi-squire test were used to assess the association between the preoperative factors and upstage to invasive cancer.


RESULTS
Compared with the overall underestimation rate (84 of 201, 41.8%), 47 (60.3%) of 78 patients with abnormal breast palpation, 46 (55.4%) of 83 patients with mammographic finding of a mass lesion, and 38 (67.9%) of 56 patients with a sonographic lesion size >20 mm had invasive cancer components on the final pathology review (Odds ratio [OR] = 2.45; P = 0.04, OR = 3.66; P = 0.002, and OR = 4.13; P = 0.002 respectively).


CONCLUSIONS
A sonographic lesion size >20 mm can be used as another guideline for surgeons to consider sentinel lymph node biopsy in patients with DCIS diagnosed by a sonographically guided CNB.
Lee
Jong Won
JW
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Han
Wonshik
W
Ko
Eunyoung
E
Cho
Jihyoung
J
Kim
Eun-Kyu
EK
Jung
So-Youn
SY
Cho
Nariya
N
Moon
Woo Kyung
WK
Park
In-Ae
IA
Noh
Dong-Young
DY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology / Q000648:ultrastructure*; D010173:Palpation; D011237:Predictive Value of Tests; D011300:Preoperative Care; D018084:Ultrasonography, Interventional