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المؤلفون: Carmen C. van der Pol, Maurice A.A.J. van den Bosch, Paul J. van Diest, Ruud M. Pijnappel, Maarten W. Barentsz, Hester Wessels, Helena M. Verkooijen, Arjen J. Witkamp
المصدر: PLoS ONE, Vol 9, Iss 7, p e103105 (2014)
PLoS ONEمصطلحات موضوعية: Adult, medicine.medical_specialty, Time Factors, Adolescent, lcsh:Medicine, Breast Neoplasms, Diagnostic accuracy, Anxiety, Malignancy, Sensitivity and Specificity, Young Adult, Breast cancer, Internal medicine, Breast Tumors, Biopsy, Medicine and Health Sciences, Cancer Detection and Diagnosis, medicine, Humans, lcsh:Science, Aged, Aged, 80 and over, Multidisciplinary, medicine.diagnostic_test, business.industry, lcsh:R, Cancers and Neoplasms, Cancer, Histology, Middle Aged, medicine.disease, Surgery, Oncology, Patient Satisfaction, Female, lcsh:Q, Disease characteristics, medicine.symptom, business, Stress, Psychological, Research Article
الوصف: Background Same-day diagnosis based on histology is increasingly being offered to patients suspected of breast cancer. We evaluated to which extent same-day diagnosis affected diagnostic accuracy and patients' anxiety levels during the diagnostic phase. Patients and methods All 759 women referred for same-day evaluation of suspicious breast lesions between November 2011–March 2013 were included. Diagnostic accuracy was assessed by linking all patients to the national pathology database to identify diagnostic discrepancies, in which case slides were reviewed. Patients' anxiety was measured in 127 patients by the State Trait and Anxiety Inventory on six moments during the diagnostic workup and changes over time (
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2
المؤلفون: Ruud M. Pijnappel, Stephanie M. W. Y. van de Ven, Petra H.M. Peeters, Suzanne C. E. Diepstraten, Helena M. Verkooijen, Maurice A.A.J. van den Bosch, Sjoerd G. Elias
المصدر: PLoS ONE
PLoS ONE, Vol 8, Iss 10, p e77826 (2013)مصطلحات موضوعية: Male, medicine.medical_specialty, lcsh:Medicine, Breast Neoplasms, Breast cancer, Surgical oncology, Biopsy, Carcinoma, Humans, Medicine, Mammography, Prospective Studies, lcsh:Science, Prospective cohort study, Aged, Multidisciplinary, medicine.diagnostic_test, Sentinel Lymph Node Biopsy, business.industry, lcsh:R, Middle Aged, Models, Theoretical, Ductal carcinoma, Sentinel node, medicine.disease, Surgery, Carcinoma, Intraductal, Noninfiltrating, lcsh:Q, Female, Biopsy, Large-Core Needle, Radiology, business, Research Article
الوصف: BACKGROUND:We aimed to develop a multivariable model for prediction of underestimated invasiveness in women with ductal carcinoma in situ at stereotactic large core needle biopsy, that can be used to select patients for sentinel node biopsy at primary surgery. METHODS:From the literature, we selected potential preoperative predictors of underestimated invasive breast cancer. Data of patients with nonpalpable breast lesions who were diagnosed with ductal carcinoma in situ at stereotactic large core needle biopsy, drawn from the prospective COBRA (Core Biopsy after RAdiological localization) and COBRA2000 cohort studies, were used to fit the multivariable model and assess its overall performance, discrimination, and calibration. RESULTS:348 women with large core needle biopsy-proven ductal carcinoma in situ were available for analysis. In 100 (28.7%) patients invasive carcinoma was found at subsequent surgery. Nine predictors were included in the model. In the multivariable analysis, the predictors with the strongest association were lesion size (OR 1.12 per cm, 95% CI 0.98-1.28), number of cores retrieved at biopsy (OR per core 0.87, 95% CI 0.75-1.01), presence of lobular cancerization (OR 5.29, 95% CI 1.25-26.77), and microinvasion (OR 3.75, 95% CI 1.42-9.87). The overall performance of the multivariable model was poor with an explained variation of 9% (Nagelkerke's R(2)), mediocre discrimination with area under the receiver operating characteristic curve of 0.66 (95% confidence interval 0.58-0.73), and fairly good calibration. CONCLUSION:The evaluation of our multivariable prediction model in a large, clinically representative study population proves that routine clinical and pathological variables are not suitable to select patients with large core needle biopsy-proven ductal carcinoma in situ for sentinel node biopsy during primary surgery.
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3دورية أكاديمية
المؤلفون: Daniëlle van der Waal, Gerard J den Heeten, Ruud M Pijnappel, Klaas H Schuur, Johanna M H Timmers, André L M Verbeek, Mireille J M Broeders
المصدر: PLoS ONE, Vol 10, Iss 9, p e0136667 (2015)
الوصف: The objective of this study is to compare different methods for measuring breast density, both visual assessments and automated volumetric density, in a breast cancer screening setting. These measures could potentially be implemented in future screening programmes, in the context of personalised screening or screening evaluation.Digital mammographic exams (N = 992) of women participating in the Dutch breast cancer screening programme (age 50-75y) in 2013 were included. Breast density was measured in three different ways: BI-RADS density (5th edition) and with two commercially available automated software programs (Quantra and Volpara volumetric density). BI-RADS density (ordinal scale) was assessed by three radiologists. Quantra (v1.3) and Volpara (v1.5.0) provide continuous estimates. Different comparison methods were used, including Bland-Altman plots and correlation coefficients (e.g., intraclass correlation coefficient [ICC]).Based on the BI-RADS classification, 40.8% of the women had 'heterogeneously or extremely dense' breasts. The median volumetric percent density was 12.1% (IQR: 9.6-16.5) for Quantra, which was higher than the Volpara estimate (median 6.6%, IQR: 4.4-10.9). The mean difference between Quantra and Volpara was 5.19% (95% CI: 5.04-5.34) (ICC: 0.64). There was a clear increase in volumetric percent dense volume as BI-RADS density increased. The highest accuracy for predicting the presence of BI-RADS c+d (heterogeneously or extremely dense) was observed with a cut-off value of 8.0% for Volpara and 13.8% for Quantra.Although there was no perfect agreement, there appeared to be a strong association between all three measures. Both volumetric density measures seem to be usable in breast cancer screening programmes, provided that the required data flow can be realized.
وصف الملف: electronic resource
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4دورية أكاديمية
المؤلفون: Maarten W Barentsz, Hester Wessels, Paul J van Diest, Ruud M Pijnappel, Carmen C van der Pol, Arjen J Witkamp, Maurice A A J van den Bosch, Helena M Verkooijen
المصدر: PLoS ONE, Vol 9, Iss 7, p e103105 (2014)
الوصف: Same-day diagnosis based on histology is increasingly being offered to patients suspected of breast cancer. We evaluated to which extent same-day diagnosis affected diagnostic accuracy and patients' anxiety levels during the diagnostic phase.All 759 women referred for same-day evaluation of suspicious breast lesions between November 2011-March 2013 were included. Diagnostic accuracy was assessed by linking all patients to the national pathology database to identify diagnostic discrepancies, in which case slides were reviewed. Patients' anxiety was measured in 127 patients by the State Trait and Anxiety Inventory on six moments during the diagnostic workup and changes over time (
وصف الملف: electronic resource
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5دورية أكاديمية
المؤلفون: Suzanne C E Diepstraten, Stephanie M W Y van de Ven, Ruud M Pijnappel, Petra H M Peeters, Maurice A A J van den Bosch, Helena M Verkooijen, Sjoerd G Elias
المصدر: PLoS ONE, Vol 8, Iss 10, p e77826 (2013)
الوصف: BACKGROUND:We aimed to develop a multivariable model for prediction of underestimated invasiveness in women with ductal carcinoma in situ at stereotactic large core needle biopsy, that can be used to select patients for sentinel node biopsy at primary surgery. METHODS:From the literature, we selected potential preoperative predictors of underestimated invasive breast cancer. Data of patients with nonpalpable breast lesions who were diagnosed with ductal carcinoma in situ at stereotactic large core needle biopsy, drawn from the prospective COBRA (Core Biopsy after RAdiological localization) and COBRA2000 cohort studies, were used to fit the multivariable model and assess its overall performance, discrimination, and calibration. RESULTS:348 women with large core needle biopsy-proven ductal carcinoma in situ were available for analysis. In 100 (28.7%) patients invasive carcinoma was found at subsequent surgery. Nine predictors were included in the model. In the multivariable analysis, the predictors with the strongest association were lesion size (OR 1.12 per cm, 95% CI 0.98-1.28), number of cores retrieved at biopsy (OR per core 0.87, 95% CI 0.75-1.01), presence of lobular cancerization (OR 5.29, 95% CI 1.25-26.77), and microinvasion (OR 3.75, 95% CI 1.42-9.87). The overall performance of the multivariable model was poor with an explained variation of 9% (Nagelkerke's R(2)), mediocre discrimination with area under the receiver operating characteristic curve of 0.66 (95% confidence interval 0.58-0.73), and fairly good calibration. CONCLUSION:The evaluation of our multivariable prediction model in a large, clinically representative study population proves that routine clinical and pathological variables are not suitable to select patients with large core needle biopsy-proven ductal carcinoma in situ for sentinel node biopsy during primary surgery.
وصف الملف: electronic resource
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