Jakub et al reported a nomogram that predicts the probability of upstaging a diagnosis of ductal carcinoma in situ (DCIS) to invasive carcinoma. The authors are from the Mayo Clinic.
Patient selection: needle core biopsy showing ductal carcinoma in situ (DCIS)
Parameters:
(1) histologic grade (low, intermediate, high)
(2) mass lesion
(3) multicentric
(4) size in centimeters, from 0 to 16 cm
points for size =
= 6.25 * (diameter in cm)
Parameter
Finding
Points
histologic grade
low
0
intermediate
31.1
high
62.2
mass lesion
no
yes
62.9
multicentric
22.3
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 247.4
• The higher the score the greater the chance of being upstaged.
Score
Percent Upstaged
< 5.6
< 3%
5.6 to 209.7
X = (0.02119 * (score)) - 3.5929;
probability of upstaging = 1/(1+EXP((-1)*X))
> 209.7
> 70%
Performance:
• The area under the ROC curve ranged from 0.59 to 0.66.
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Specialty: Hematology Oncology
