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Predictors of Invasive Breast Cancer in Patients With Ductal Carcinoma In Situ in Ultrasound‐Guided Core Needle Biopsy
Author(s) -
Shin Yoon Joo,
Kim Sun Mi,
Yun Bo La,
Jang Mijung,
Kim Bohyoung,
Lee Soo Hyun
Publication year - 2019
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14722
Subject(s) - medicine , ductal carcinoma , echogenicity , radiology , biopsy , breast imaging , mammography , bi rads , breast cancer , ultrasound , logistic regression , cancer
Objectives To determine predictors of invasiveness of lesions with US‐guided biopsy‐confirmed ductal carcinoma in situ (DCIS), focusing on US features, including shear wave elastography (SWE). Methods From January 2015 to September 2016, a total of 80 lesions with US‐guided biopsy‐confirmed DCIS were detected in patients who underwent preoperative mammography, B‐mode US, and SWE. Data were retrospectively reviewed from clinical records, pathologic reports, and imaging assessments. Imaging data included mammographic findings, B‐mode US findings based on the American College of Radiology Breast Imaging Reporting and Data System (BI‐RADS), and the mean and maximum elasticity values on SWE. The final BI‐RADS assessment, including the degree of elasticity of the mass, was evaluated. Continuous variables were examined by an independent t test, and categorical variables were examined by the Fisher exact test. The independent factors for predicting a histologic upgrade were evaluated by a multivariate logistic regression analysis. Results Among the 80 lesions, 27 (33.8%) showed an invasive component after surgical excision. None of the BI‐RADS US descriptors, which include shape, orientation, margin, and echogenicity, showed a significant correlation with the rate of a histologic upgrade to invasive cancer. However, the BI‐RADS assessment category ( P = .015) and nuclear grade ( P = .005) were significantly correlated with invasiveness of the mass. The maximum stiffness value was lower in the pure DCIS group (119.04 vs 85.33 kPa; P = .041). Conclusions The BI‐RADS category based on US findings, maximum stiffness value on SWE, and nuclear grade of DCIS are predictive of invasive components in DCIS.