Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy.
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 selecte...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3795649?pdf=render |
| _version_ | 1811225347462529024 |
|---|---|
| author | 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 |
| author_facet | 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 |
| author_sort | Suzanne C E Diepstraten |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T09:05:35Z |
| format | Article |
| id | doaj.art-0732f386653e47c6b7de8a3a7c463c9d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T09:05:35Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-0732f386653e47c6b7de8a3a7c463c9d2022-12-22T03:39:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01810e7782610.1371/journal.pone.0077826Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy.Suzanne C E DiepstratenStephanie M W Y van de VenRuud M PijnappelPetra H M PeetersMaurice A A J van den BoschHelena M VerkooijenSjoerd G EliasBACKGROUND: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.http://europepmc.org/articles/PMC3795649?pdf=render |
| spellingShingle | 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 Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy. PLoS ONE |
| title | Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy. |
| title_full | Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy. |
| title_fullStr | Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy. |
| title_full_unstemmed | Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy. |
| title_short | Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy. |
| title_sort | development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy |
| url | http://europepmc.org/articles/PMC3795649?pdf=render |
| work_keys_str_mv | AT suzannecediepstraten developmentandevaluationofapredictionmodelforunderestimatedinvasivebreastcancerinwomenwithductalcarcinomainsituatstereotacticlargecoreneedlebiopsy AT stephaniemwyvandeven developmentandevaluationofapredictionmodelforunderestimatedinvasivebreastcancerinwomenwithductalcarcinomainsituatstereotacticlargecoreneedlebiopsy AT ruudmpijnappel developmentandevaluationofapredictionmodelforunderestimatedinvasivebreastcancerinwomenwithductalcarcinomainsituatstereotacticlargecoreneedlebiopsy AT petrahmpeeters developmentandevaluationofapredictionmodelforunderestimatedinvasivebreastcancerinwomenwithductalcarcinomainsituatstereotacticlargecoreneedlebiopsy AT mauriceaajvandenbosch developmentandevaluationofapredictionmodelforunderestimatedinvasivebreastcancerinwomenwithductalcarcinomainsituatstereotacticlargecoreneedlebiopsy AT helenamverkooijen developmentandevaluationofapredictionmodelforunderestimatedinvasivebreastcancerinwomenwithductalcarcinomainsituatstereotacticlargecoreneedlebiopsy AT sjoerdgelias developmentandevaluationofapredictionmodelforunderestimatedinvasivebreastcancerinwomenwithductalcarcinomainsituatstereotacticlargecoreneedlebiopsy |