Huo et al identified factors that can help identify a patient with ductal carcinoma in situ (DCIS) diagnosed on needle core biopsy who is likely to have invasive carcinoma. This can help select patients for sentinel lymph node biopsy. The authors are from M.D. Anderson Cancer Center in Houston.
Parameters:
(1) lesion seen on imaging studies as calcification (Ca+2) vs mass
(2) cancerization of the lobules
(3) size of the lesion in cm
(4) nuclear grade (Grade 1 = low; Grade 2 or 3 = high)
|
Ca+2/Mass |
Cancerization |
size in cm |
nuclear grade |
Probability |
|
Ca+2 |
no |
<= 1.5 cm |
low |
0.0195 |
|
Ca+2 |
no |
<= 1.5 cm |
high |
0.086 |
|
Ca+2 |
no |
> 1.5 cm |
low |
0.057 |
|
Ca+2 |
no |
> 1.5 cm |
high |
0.224 |
|
Ca+2 |
yes |
<= 1.5 cm |
low |
0.047 |
|
Ca+2 |
yes |
<= 1.5 cm |
high |
0.189 |
|
Ca+2 |
yes |
> 1.5 cm |
low |
0.130 |
|
Ca+2 |
yes |
> 1.5 cm |
high |
0.415 |
|
mass |
no |
<= 1.5 cm |
low |
0.046 |
|
mass |
no |
<= 1.5 cm |
high |
0.185 |
|
mass |
no |
> 1.5 cm |
low |
0.128 |
|
mass |
no |
> 1.5 cm |
high |
0.410 |
|
mass |
yes |
<= 1.5 cm |
low |
0.106 |
|
mass |
yes |
<= 1.5 cm |
high |
0.360 |
|
mass |
yes |
> 1.5 cm |
low |
0.265 |
|
mass |
yes |
> 1.5 cm |
high |
0.632 |
where:
• The odds ratio for mass lesion and lobular cancerization was about 2.4. The odds ratio for a lesion > 1.5 cm was 3.1, while nuclear grade was 4.8 (with a p value 0.14).
Interpretation:
• Probabilities <= 0.19 was considered low.
• A probability >= 0.22 was considered high.
• A patient with a high probability of lymph node metastases was a candidate for sentinel lymph node biopsy.
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
ICD-10: ,
