Timmers et al reported a nomogram for identifying a woman with breast cancer based on findings seen on a screening mammography. This can help to identify a woman who should undergo a more complete breast evaluation. The authors are from Radboud University Medical Centre, University Medical Centre Utrecht and the University of Amsterdam in the Netherlands.
Patient selection: woman from 50 to 75 years of age with a mammogram
Parameters:
(1) age in years
(2) features of a breast mass
(3) microcalcifications in a cluster
(4) architectural distortion
(5) focal asymmetry
|
Parameter |
Finding |
Points |
|
age in years |
50 to 54 |
0 |
|
|
55 to 75 |
10.6 |
|
features of the mass |
none |
0 |
|
|
well-defined |
14.7 |
|
|
ill-defined |
49.4 |
|
|
speculated |
100 |
|
microcalcifications in a cluster |
no |
0 |
|
|
yes |
39.3 |
|
architectural distortion |
no |
0 |
|
|
yes |
29.4 |
|
focal asymmetry |
no |
0 |
|
|
yes |
13 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 192.3
• The higher the score the greater the risk of breast cancer.
|
Score |
Percent with Breast Cancer |
|
< 13 |
< 5% |
|
13 to 63 |
(0.01428 * ((points)^2)) - (0.1893 * (points)) + 5.186 |
|
63 to 82 |
(1.34 * (points) - 34.75 |
|
82 to 113 |
(-0.009208 * ((points)^2)) + (2.452 * (points)) - 63.9 |
|
113. to 140 |
95 to 99% |
|
> 140 |
> 99% |
Performance:
• The area under the ROC curve was 0.78.
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
