دورية أكاديمية
Atypical Ductal Hyperplasia of the Breast on Core Needle Biopsy: Risk of Malignant Upgrade on Surgical Excision.
| العنوان: | Atypical Ductal Hyperplasia of the Breast on Core Needle Biopsy: Risk of Malignant Upgrade on Surgical Excision. |
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| المؤلفون: | Bong TSH; Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore., Tan JKT; Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore., Ho JTS; Division of Oncologic Imaging, National Cancer Centre Singapore, Singapore., Tan PH; Division of Pathology, Singapore General Hospital, Singapore., Lau WS; Department of Clinical Laboratory, Gleneagles Hospital Hong Kong, Hong Kong., Tan TM; Department of Statistics and Applied Probability, National University of Singapore, Singapore., Wong JSL; Division of Oncologic Imaging, National Cancer Centre Singapore, Singapore., Tan VKM; Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.; Department of Breast Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore.; SingHealth Duke-NUS Breast Centre, Singapore., Tan BKT; Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.; Department of Breast Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore.; SingHealth Duke-NUS Breast Centre, Singapore.; Department of General Surgery, Sengkang General Hospital, Singapore., Madhukumar P; Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.; Department of Breast Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore.; SingHealth Duke-NUS Breast Centre, Singapore., Yong WS; Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.; Department of Breast Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore.; SingHealth Duke-NUS Breast Centre, Singapore., Lim SZ; Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.; Department of Breast Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore.; SingHealth Duke-NUS Breast Centre, Singapore., Wong CY; Department of Breast Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore.; SingHealth Duke-NUS Breast Centre, Singapore., Ong KW; Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.; Department of Breast Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore.; SingHealth Duke-NUS Breast Centre, Singapore., Sim Y; Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.; Department of Breast Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore.; SingHealth Duke-NUS Breast Centre, Singapore. sim.yirong@singhealth.com.sg. |
| المصدر: | Journal of breast cancer [J Breast Cancer] 2022 Feb; Vol. 25 (1), pp. 37-48. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Korean Breast Cancer Society Country of Publication: Korea (South) NLM ID: 101314183 Publication Model: Print Cited Medium: Print ISSN: 1738-6756 (Print) Linking ISSN: 17386756 NLM ISO Abbreviation: J Breast Cancer Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Seoul : Korean Breast Cancer Society |
| مستخلص: | Purpose: This study identified factors predicting malignant upgrade for atypical ductal hyperplasia (ADH) diagnosed on core-needle biopsy (CNB) and developed a nomogram to facilitate evidence-based decision making. Methods: This retrospective analysis included women diagnosed with ADH at the National Cancer Centre Singapore (NCCS) in 2010-2015. Cox proportional hazards regression was used to identify clinical, radiological, and histological factors associated with malignant upgrade. A nomogram was constructed using variables with the strongest associations in multivariate analysis. Multivariable logistic regression coefficients were used to estimate the predicted probability of upgrade for each factor combination. Results: Between 2010 and 2015, 238,122 women underwent mammographic screening under the National Breast Cancer Screening Program. Among 29,564 women recalled, 5,971 CNBs were performed. Of these, 2,876 underwent CNBs at NCCS, with 88 patients (90 lesions) diagnosed with ADH and 26 lesions upgraded to breast malignancy on excision biopsy. In univariate analysis, factors associated with malignant upgrade were the presence of a mass on ultrasound ( p = 0.018) or mammography ( p = 0.026), microcalcifications ( p = 0.047), diffuse microcalcification distribution ( p = 0.034), mammographic parenchymal density ( p = 0.008). and ≥ 3 separate ADH foci found on biopsy ( p = 0.024). Mammographic parenchymal density (hazard ratio [HR], 0.04; 95% confidence interval [CI], 0.005-0.35; p = 0.014), presence of a mass on ultrasound (HR, 10.50; 95% CI, 9.21-25.2; p = 0.010), and number of ADH foci (HR, 1.877; 95% CI, 1.831-1.920; p = 0.002) remained significant in multivariate analysis and were included in the nomogram. Conclusion: Our model provided good discrimination of breast cancer risk prediction (C-statistic of 0.81; 95% CI, 0.74-0.88) and selected for a subset of women at low risk (2.1%) of malignant upgrade, who may avoid surgical excision following a CNB diagnosis of ADH. Competing Interests: The authors declare that they have no competing interests. (© 2022 Korean Breast Cancer Society.) |
| References: | Hum Pathol. 1992 Oct;23(10):1095-7. (PMID: 1328030) Breast. 2013 Aug;22(4):537-42. (PMID: 23237921) Cancer. 2003 Aug 1;98(3):590-6. (PMID: 12879477) Am J Clin Pathol. 2003 Feb;119(2):248-53. (PMID: 12579995) Menopause. 2007 Sep-Oct;14(5):891-9. (PMID: 17414171) N Engl J Med. 2015 Jan 1;372(1):78-89. (PMID: 25551530) AJR Am J Roentgenol. 2009 Jan;192(1):229-34. (PMID: 19098204) Radiology. 1993 Dec;189(3):667-71. (PMID: 8234688) Mod Pathol. 2003 Feb;16(2):154-60. (PMID: 12591968) Breast Cancer Res Treat. 1993 Nov;28(2):157-66. (PMID: 8173068) Breast. 2011 Apr;20 Suppl 2:S75-80. (PMID: 21316967) Breast. 2007 Apr;16(2):113-9. (PMID: 17081753) Ann Surg Oncol. 2017 Jan;24(1):70-76. (PMID: 27573525) Cancer. 1985 Jun 1;55(11):2698-708. (PMID: 2986821) World J Surg Oncol. 2009 Oct 23;7:77. (PMID: 19852801) Breast Cancer Res. 2006;8(3):R30. (PMID: 16796758) Radiology. 2002 Aug;224(2):548-54. (PMID: 12147855) Pathology. 2002 Oct;34(5):410-6. (PMID: 12408338) Breast Cancer Res Treat. 2017 Jul;164(2):295-304. (PMID: 28474262) Histopathology. 1996 Jun;28(6):537-41. (PMID: 8803597) Am J Surg Pathol. 2001 Aug;25(8):1017-21. (PMID: 11474285) Br J Cancer. 2002 Oct 7;87(8):876-82. (PMID: 12373602) Ann Surg Oncol. 2011 Mar;18(3):752-61. (PMID: 20972636) BMJ. 2014 Feb 11;348:g366. (PMID: 24519768) Ann Epidemiol. 2001 May;11(4):257-63. (PMID: 11306344) J Clin Epidemiol. 1996 Dec;49(12):1373-9. (PMID: 8970487) Arch Pathol Lab Med. 2003 Jan;127(1):49-54. (PMID: 12521366) |
| فهرسة مساهمة: | Keywords: Breast; Carcinoma in Situ; Carcinoma, Intraductal, Noninfiltrating; Nomograms; Prognosis |
| تواريخ الأحداث: | Date Created: 20220224 Latest Revision: 20220309 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC8876544 |
| DOI: | 10.4048/jbc.2022.25.e7 |
| PMID: | 35199500 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1738-6756 |
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| DOI: | 10.4048/jbc.2022.25.e7 |