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Identifying a subset of patients with DCIS who have a low likelihood of residual disease at surgical excision following a core needle biopsy
Author(s) -
Murphy Brittany L.,
Gonzalez Alexandra B.,
Conners Amy L.,
Henrichsen Tara L.,
Keeney Michael G.,
Chen Beiyun,
Nguyen Toan T.,
Harmsen William S.,
Habermann Elizabeth B.,
Shah Harsh N.,
Jakub James W.
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24649
Subject(s) - medicine , biopsy , ductal carcinoma , radiology , surgery , disease , surgical pathology , mammography , residual , core biopsy , multivariate analysis , breast cancer , cancer , algorithm , computer science
Background and Objectives Current randomized controlled trials are investigating the outcomes of non‐surgical treatment for patients with ductal carcinoma in situ (DCIS). We sought to evaluate pre‐operative factors associated with no residual disease at definitive resection following a core needle biopsy (CNB) diagnosis of DCIS. Methods Eight hundred and thirty‐four operations for DCIS were performed at our institution between January 2004 and October 2014. We evaluated patient and biopsy tumor characteristics to determine pre‐operative factors associated with no residual disease at surgical resection using uni‐ and multivariable analyses. Results Sixty‐nine patients (8%) had no residual disease on final pathology. On multivariable analysis, low‐ or intermediate‐grade lesions, <1 cm in size on mammography, and lesions where ≥90% of calcifications were removed correlated with finding no residual disease on final pathology, c‐statistic 0.84. Of the 14 patients with all three low‐risk factors, 36% had no residual disease on final pathology. Conclusions Although our multivariable analysis performed well, its clinical utility would be limited as we were unable to identify a subset of patients with DCIS in whom the probability of finding no residual disease is low enough to consider routine use of non‐surgical management.