Identifying a subset of patients with DCIS who have a low likelihood of residual disease at surgical excision following a core needle biopsy

Brittany L. Murphy, Alexandra B. Gonzalez, Amy L. Conners, Tara L. Henrichsen, Michael G. Keeney, Beiyun Chen, Toan T. Nguyen, William S. Harmsen, Elizabeth B Habermann, Harsh N. Shah, James W Jakub

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)213-219
Number of pages7
JournalJournal of Surgical Oncology
Volume116
Issue number2
DOIs
StatePublished - Aug 1 2017

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Keywords

  • core needle biopsy
  • DCIS
  • ductal carcinoma in situ
  • invasive
  • no residual disease
  • progression
  • upstage

ASJC Scopus subject areas

  • Surgery
  • Oncology

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