title: Sonoelastographic lesion stiffness: preoperative predictor of the presence of an invasive focus in nonpalpable DCIS diagnosed at US-guided needle biopsy.
abstract: OBJECTIVE
  To retrospectively evaluate whether sonoelastographic evaluation could help predict the presence of an invasive focus in nonpalpable DCIS diagnosed at US-guided needle biopsy.
  
  
  METHODS
  One hundred and three consecutive nonpalpable DCIS lesions diagnosed at US-guided needle biopsy were analyzed. To identify the preoperative factors associated with upgrade to invasive cancers on surgical histology, lesion size, B-mode US findings, elasticity score, biopsy variables, and histological variables were analyzed using univariate and multivariate logistic regression. Interobserver agreement for the elasticity score was evaluated using the multi-rater κ statistics.
  
  
  RESULTS
  The overall upgrade rate was 23% (24 of 103). Elasticity score was found to be the only independent predictor of invasion. The upgrade rates according to the median elasticity score was 6.7% (1 of 15) for a score of 1, 20.6% (13 of 63) for a score of 2, and 40.0% (10 of 25) for a score of 3 (Odds ratio [OR] = 1; OR = 4.19, P = 0.207; OR = 12.32, P = 0.039, respectively). No association was found between other factors and the upgrade rate. The overall interobserver agreement for the elasticity score was moderate (κ = 0.587; P < .001).
  
  
  CONCLUSIONS
  Sonoelastographic lesion stiffness is an independent preoperative predictor of invasion in some patients with nonpalpable DCIS at US-guided needle biopsy.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul 100-744, Republic of Korea.
authors.forename: Nariya
authors.initials: N
authors.lastname: Cho
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Chang
authors.forename: Ann
authors.initials: A
authors.lastname: Yi
authors.forename: Hye Ryoung
authors.initials: HR
authors.lastname: Koo
authors.forename: Jeong-Seon
authors.initials: JS
authors.lastname: Park
authors.forename: In Ae
authors.initials: IA
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary / Q000379:methods*