caa a22 4500 445336846 CHVBK 20180317142758.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1245/s10434-010-1438-9 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1438-9 Accuracy of a Preoperative Model for Predicting Invasive Breast Cancer in Women with Ductal Carcinoma-in-situ on Vacuum-Assisted Core Needle Biopsy [Elektronische Daten] [Nehmat Houssami, Daniela Ambrogetti, M. Marinovich, Simonetta Bianchi, Petra Macaskill, Vania Vezzosi, Eleftherios Mamounas, Stefano Ciatto] Background: Core needle biopsy (CNB) diagnoses of ductal carcinoma-in-situ (DCIS) may represent understaged invasive breast cancer (IBC). We aimed to develop a model that helps identify preoperatively women with IBC after a CNB diagnosis of DCIS. Methods: Retrospective study of all women with DCIS on vacuum-assisted CNB of microcalcifications (1999-2008), with prospective classification of imaging variables independently by two radiologists. Variables included lesion size and level of suspicion on imaging, morphology and distribution of microcalcifications, DCIS nuclear grade on CNB, number of cores, and age. Multivariate logistic regression models of the probability of IBC were developed; the accuracy of these models was examined for each radiologist. Results: Excision histology showed IBC in 77 (17.4%) of 442 subjects with DCIS on CNB. Lesion size on imaging yielded the best model fit and highest accuracy, and had the highest agreement between radiologists. Addition of grade to a model which included size improved model fit (P<0.0001). However, model fit and accuracy were not improved by inclusion of any other variables. A model based on size and grade had similar areas under the receiver operating characteristic curve (accuracy of 74%) for each radiologist. Modeled sensitivity, specificity, and predictive values for different combinations of size and grade thresholds are reported. If the imaging lesion is >50mm and the CNB grade is high, the model's positive predictive value is ≥50%. Conclusions: A model based on imaging size of microcalcifications and CNB nuclear grade can identify women at high risk of having IBC with moderate accuracy and may be used to guide informed preoperative discussion in women with newly diagnosed DCIS on CNB. Society of Surgical Oncology, 2010 Houssami Nehmat Screening and Test Evaluation Program (STEP), School of Public Health, A27, Sydney Medical School, University of Sydney, Sydney, NSW, Australia aut Ambrogetti Daniela Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy aut Marinovich M. Screening and Test Evaluation Program (STEP), School of Public Health, A27, Sydney Medical School, University of Sydney, Sydney, NSW, Australia aut Bianchi Simonetta Department of Medical and Surgical Critical Care, Division of Pathological Anatomy, University of Florence, Florence, Italy aut Macaskill Petra Screening and Test Evaluation Program (STEP), School of Public Health, A27, Sydney Medical School, University of Sydney, Sydney, NSW, Australia aut Vezzosi Vania Department of Medical and Surgical Critical Care, Division of Pathological Anatomy, University of Florence, Florence, Italy aut Mamounas Eleftherios Aultman Health Foundation, Canton, OH, USA aut Ciatto Stefano Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy aut Annals of Surgical Oncology Springer-Verlag 18/5(2011-05-01), 1364-1371 1068-9265 18:5<1364 2011 18 10434 https://doi.org/10.1245/s10434-010-1438-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1438-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Houssami Nehmat Screening and Test Evaluation Program (STEP), School of Public Health, A27, Sydney Medical School, University of Sydney, Sydney, NSW, Australia aut NATIONALLICENCE 700 1- Ambrogetti Daniela Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy aut NATIONALLICENCE 700 1- Marinovich M. Screening and Test Evaluation Program (STEP), School of Public Health, A27, Sydney Medical School, University of Sydney, Sydney, NSW, Australia aut NATIONALLICENCE 700 1- Bianchi Simonetta Department of Medical and Surgical Critical Care, Division of Pathological Anatomy, University of Florence, Florence, Italy aut NATIONALLICENCE 700 1- Macaskill Petra Screening and Test Evaluation Program (STEP), School of Public Health, A27, Sydney Medical School, University of Sydney, Sydney, NSW, Australia aut NATIONALLICENCE 700 1- Vezzosi Vania Department of Medical and Surgical Critical Care, Division of Pathological Anatomy, University of Florence, Florence, Italy aut NATIONALLICENCE 700 1- Mamounas Eleftherios Aultman Health Foundation, Canton, OH, USA aut NATIONALLICENCE 700 1- Ciatto Stefano Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/5(2011-05-01), 1364-1371 1068-9265 18:5<1364 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer