Úvod: Díky mamografickému screeningu a zlepšování diagnostiky karcinomu prsu narůstá také záchyt prekanceróz. Jsou definovány jako morfologické změny mléčné žlázy, u kterých je vyšší pravděpodobnost vzniku karcinomu. Hodnocené prekancerózy jsou atypická duktální hyperplazie (ADH), lobulární karcinom in situ (LCIS) a radiální jizva. Metodika: V období 1. 1. 2018–31. 12. 2022 jsme na Chirurgické klinice FN Plzeň provedli 1 302 plánovaných operací pro onemocnění prsu, z toho 30 operací prekanceróz (2 %). O ADH se jednalo 11×, 8× o LCIS, 11× o radiální jizvu. Průměrný věk pacientek byl ve všech třech skupinách 56 let (27–85). Prekanceróza byla diagnostikována 8× pouze sonograficky, 3× mamograficky a 19× kombinací obou metod. Následně byla vždy doplněna punkční biopsie. Excizi tumoru s peroperační biopsií jsme provedli 28×, 2× mastektomii. Výsledky: V případě ADH z punkční biopsie se peroperačně potvrdila 8× ADH, 2× byl diagnostikován duktální karcinom in situ (ductal carcinoma in situ – DCIS), 1× mucinózní karcinom. U LCIS nebyl peroperační biopsií 4× tumor nalezen, 1× potvrzen LCIS, 1× diagnostikován lobulární invazivní karcinom, 2× provedena mastektomie bez peroperační biopsie. U radiální jizvy 3× diagnostikována ADH, 6× sklerozující adenóza, 1× DCIS, 1× invazivní karcinom. Po definitivním histologickém zpracování vzorků došlo ještě k nárůstu diagnostikovaných karcinomů. U ADH 3× DCIS, 2× DIC, 1× mucinózní karcinom. U LCIS 3× LIC. U radiální jizvy zůstává 1× DCIS a 1× invazivní karcinom. Tedy u 11 pacientek (37 %) byl díky operačnímu řešení diagnostikován karcinom. U žádné pacientky nebyla provedena operace axilárních uzlin. Všech 11 pacientek následně podstoupilo onkologickou léčbu, vždy kombinace radioterapie a hormonální terapie. Všechny pacientky žijí, 10 pacientek je v kompletní remisi onemocnění, u jedné s DCIS došlo po 4 letech k lokální recidivě. Závěr: Chirurgická léčba prekanceróz prsu má smysl, často se vedle prekancerózy skrývá už DCIS, či dokonce invazivní karcinom. Díky operačnímu řešení došlo k odhalení nádorového onemocnění včas.

Introduction: Thanks to mammographic screening and the improvement of breast cancer diagnostics, the detection of precancers is also increasing. They are defined as morphological changes of the mammary gland which are more likely to cause cancer. The evaluated precancers are atypical ductal hyperplasia (ADH), lobular carcinoma in situ (LCIS) and radial scar. Methodology: In the period 1. 1. 2018–31. 12. 2022, we performed 1,302 planned operations for breast disease at the Surgical Clinic of Teaching Hospital Plzeň, of which 30 (2%) were precancer operations. ADH was confirmed 11×, LCIS 8×, and a radical scar 11×. The average age of the patients in all three groups was 56 years (27–85). Precancer was diagnosed 8× only by sonography, 3× by mammography and 19× by a combination of both methods. Subsequently, a puncture biopsy was always completed. We performed 28 tumor excisions with intraoperative biopsy and 2 mastectomies. Results: In the case of ADH from puncture biopsy, ADH was confirmed intraoperatively 8×, DCIS was diagnosed 2×, and mucinous carcinoma 1×. In LCIS, no tumor was found by intraoperative biopsy 4×, LCIS was confirmed 1×, lobular invasive carcinoma was diagnosed 1×, mastectomy was performed 2× without intraoperative biopsy. In the radial scar, ADH was diagnosed 3×, sclerosing adenosis 6×, DCIS 1×, invasive carcinoma 1×. After the final histological processing of the samples, there was an increase in diagnosed carcinomas. In ADH, DCIS was confirmed 3×, DIC 2×, and mucinous carcinoma 1×. In LCIS, LIC was diagnosed 3×. In the radial scar, DCIS was confirmed 1×, and invasive carcinoma remain 1×. Thus, carcinoma was diagnosed in 11 patients (37%) thanks to the surgical solution. No patient underwent axillary node surgery. All 11 patients subsequently underwent oncological treatment, always a combination of radiotherapy and hormone therapy. All patients are alive, 10 patients are in complete remission of the disease, one with DCIS experienced a local recurrence after 4 years. Conclusion: Surgical treatment of precancers of the breast makes sense, DCIS or even invasive cancer is often hidden in addition to precancer. Thanks to the surgical solution, the cancer was detected in time.

• MeSH
• dospělí MeSH
• intraduktální neinfiltrující karcinom chirurgie   diagnostické zobrazování   patologie   MeSH
• karcinom prsu in situ chirurgie   diagnostické zobrazování   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mamografie MeSH
• nádory prsu * chirurgie   diagnostické zobrazování   patologie   MeSH
• prekancerózy * chirurgie   diagnostické zobrazování   patologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

• MeSH
• biopsie MeSH
• cystosarcoma phyllodes diagnóza   patologie   terapie   MeSH
• fibroadenom diagnóza   patologie   terapie   MeSH
• fibrocystická nemoc prsu diagnóza   patologie   terapie   MeSH
• hamartom diagnóza   patologie   terapie   MeSH
• intraduktální neinfiltrující karcinom diagnóza   patologie   terapie   MeSH
• lidé MeSH
• lipom chirurgie   diagnóza   patologie   MeSH
• mamografie MeSH
• mastodynie etiologie   farmakoterapie   MeSH
• nádory prsu * diagnóza   patologie   terapie   MeSH
• nemoci prsů MeSH
• papilom intraduktální diagnóza   patologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH

BACKGROUND: Several randomised, phase 3 trials have investigated the value of different techniques of accelerated partial breast irradiation (APBI) for patients with early breast cancer after breast-conserving surgery compared with whole-breast irradiation. In a phase 3 randomised trial, we evaluated whether APBI using multicatheter brachytherapy is non-inferior compared with whole-breast irradiation. Here, we present the 10-year follow-up results. METHODS: We did a randomised, phase 3, non-inferiority trial at 16 hospitals and medical centres in Austria, Czech Republic, Germany, Hungary, Poland, Spain, and Switzerland. Patients aged 40 years or older with early invasive breast cancer or ductal carcinoma in situ treated with breast-conserving surgery were centrally randomly assigned (1:1) to receive either whole-breast irradiation or APBI using multicatheter brachytherapy. Whole-breast irradiation was delivered in 25 daily fractions of 50 Gy over 5 weeks, with a supplemental boost of 10 Gy to the tumour bed, and APBI was delivered as 30·1 Gy (seven fractions) and 32·0 Gy (eight fractions) of high-dose-rate brachytherapy in 5 days or as 50 Gy of pulsed-dose-rate brachytherapy over 5 treatment days. Neither patients nor investigators were masked to treatment allocation. The primary endpoint was ipsilateral local recurrence, analysed in the as-treated population; the non-inferiority margin for the recurrence rate difference (defined for 5-year results) was 3 percentage points. The trial is registered with ClinicalTrials.gov, NCT00402519; the trial is complete. FINDINGS: Between April 20, 2004, and July 30, 2009, 1328 female patients were randomly assigned to whole breast irradiation (n=673) or APBI (n=655), of whom 551 in the whole-breast irradiation group and 633 in the APBI group were eligible for analysis. At a median follow-up of 10·36 years (IQR 9·12-11·28), the 10-year local recurrence rates were 1·58% (95% CI 0·37 to 2·8) in the whole-breast irradiation group and 3·51% (1·99 to 5·03) in the APBI group. The difference in 10-year rates between the groups was 1·93% (95% CI -0·018 to 3·87; p=0·074). Adverse events were mostly grade 1 and 2, in 234 (60%) of 393 participants in the whole-breast irradiation group and 314 (67%) of 470 participants in the APBI group, at 7·5-year or 10-year follow-up, or both. Patients in the APBI group had a significantly lower incidence of treatment-related grade 3 late side-effects than those in the whole-breast irradiation group (17 [4%] of 393 for whole-breast irradiation vs seven [1%] of 470 for APBI; p=0·021; at 7·5-year or 10-year follow-up, or both). At 10 years, the most common type of grade 3 adverse event in both treatment groups was fibrosis (six [2%] of 313 patients for whole-breast irradiation and three [1%] of 375 patients for APBI, p=0·56). No grade 4 adverse events or treatment-related deaths have been observed. INTERPRETATION: Postoperative APBI using multicatheter brachytherapy after breast-conserving surgery in patients with early breast cancer is a valuable alternative to whole-breast irradiation in terms of treatment efficacy and is associated with fewer late side-effects. FUNDING: German Cancer Aid, Germany.

• MeSH
• brachyterapie * škodlivé účinky   MeSH
• intraduktální neinfiltrující karcinom * patologie   MeSH
• lidé MeSH
• lokální recidiva nádoru chirurgie   MeSH
• nádory prsu * patologie   MeSH
• segmentální mastektomie škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

• MeSH
• hlava patologie   MeSH
• intraduktální neinfiltrující karcinom * patologie   MeSH
• lidé MeSH
• nádory podčelistní slinné žlázy * diagnóza   patologie   MeSH
• podčelistní slinná žláza diagnostické zobrazování   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

Salivary gland carcinomas represent a heterogeneous group of poorly characterized head and neck tumors. The purpose of this study was to evaluate ALK gene and protein aberrations in a large, well-characterized cohort of these tumors. A total of 182 salivary gland carcinomas were tested for anaplastic lymphoma kinase (ALK) positivity by immunohistochemistry (IHC) using the cut-off of 10% positive cells. ALK positive tumors were subjected to FISH analysis and followed by hybrid capture-based next generation sequencing (NGS). Of the 182 tumors, 8 were ALK positive by IHC. Further analysis using hybrid capture NGS analysis revealed a novel MYO18A (Exon1-40)-ALK (exon 20-29) gene fusion in one case of intraductal carcinoma. Additional genomic analyses resulted in the detection of inactivating mutations in BRAF and TP53, as well as amplifications of ERBB2 and ALK. ALK rearrangements are a rare entity in salivary gland carcinomas. We identified a potentially targetable novel ALK fusion in an intraductal carcinoma of minor salivary glands.

• MeSH
• amplifikace genu MeSH
• anaplastická lymfomová kináza genetika   MeSH
• dítě MeSH
• dospělí MeSH
• fúze genů MeSH
• hybridizace in situ fluorescenční MeSH
• imunohistochemie MeSH
• intraduktální neinfiltrující karcinom enzymologie   genetika   patologie   MeSH
• karcinom enzymologie   genetika   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádorové biomarkery genetika   MeSH
• nádory slinných žláz enzymologie   genetika   patologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vysoce účinné nukleotidové sekvenování MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Pleomorphic and Florid Lobular carcinoma in situ (P/F LCIS) are rare variants of LCIS, the exact nature of which is still debated. AIM: To collect a large series of P/F LCIS diagnosed on preoperative biopsies and evaluate their association with invasive carcinoma and high grade duct carcinoma in situ (DCIS). Data obtained were compared with those reported in the literature. METHODS: A multi-institutional series of P/F LCIS was retrieved. All cases were diagnosed on pre-operative biopsies, which was followed by an open surgical excision. Data on post-operative histopathology were available. A literature review was performed. RESULTS: A total of 117 cases were collected; invasive carcinoma and/or DCIS was present in 78/117 cases (66.7%). Seventy cases of P/F LCIS were pure on biopsy and 31 of these showed pathological upgrade in post-surgical specimens. Pre-operative biopsy accuracy was 47/78 (60.3%); pre-operative biopsy underestimation of cancer was 31/78 (39,7.%). In the literature review papers, invasive carcinoma or DCIS was associated with 274 of 418 (65.5%) cases of P/F LCIS. Pre-operative biopsy accuracy was 66% (181/274) whereas pre-operative biopsy underestimation of cancer was 33.9% (93/274). CONCLUSIONS: The data presented here indicate that P/F LCIS is frequently associated with invasive carcinoma or high grade DCIS and that pre-operative biopsy is associated with an underestimation of malignancy. Open surgery is indicated when P/F LCIS is diagnosed pre-operatively.

• MeSH
• biopsie MeSH
• dospělí MeSH
• duktální karcinom prsu patologie   chirurgie   MeSH
• intraduktální neinfiltrující karcinom patologie   chirurgie   MeSH
• invazivní růst nádoru MeSH
• karcinom prsu in situ patologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lobulární karcinom patologie   chirurgie   MeSH
• nádory prsu patologie   chirurgie   MeSH
• resekční okraje MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stupeň nádoru MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH

Intraductal carcinoma (IC) is the new World Health Organization designation for tumors previously called "low-grade cribriform cystadenocarcinoma" and "low-grade salivary duct carcinoma." The relationship of IC to salivary duct carcinoma is controversial, but they now are considered to be distinct entities. IC is a rare low-grade malignant salivary gland neoplasm with features similar to mammary atypical ductal hyperplasia or ductal carcinoma in situ, that shows diffuse S100 protein and mammaglobin positivity and is only partially defined genetically. (Mammary analogue) secretory carcinoma harboring ETV6-NTRK3, and in rare cases ETV6-RET fusion, shares histomorphologic and immunophenotypical features with IC. Recently, RET rearrangements and NCOA4-RET have been described in IC, suggesting a partial genetic overlap with mammary analogue secretory carcinoma. Here, we genetically characterize the largest cohort of IC to date to further explore this relationship. Seventeen cases of IC were analyzed by next-generation sequencing using the FusionPlex Solid Tumor kit (ArcherDX). Identified fusions were confirmed using fluorescence in situ hybridization break apart and, in some cases, fusion probes, and a reverse transcription polymerase chain reaction designed specifically to the detected breakpoints. All analyzed cases were known to be negative for ETV6 rearrangement by fluorescence in situ hybridization and for ETV6-NTRK3 fusion by reverse transcription polymerase chain reaction. Next-generation sequencing analysis detected a NCOA4-RET fusion transcript joining exon 7 or 8 of NCOA4 gene and exon 12 of RET gene in 6 cases of intercalated duct type IC; and a novel TRIM27-RET fusion transcript between exons 3 and 12 in 2 cases of salivary gland tumors displaying histologic and immunohistochemical features typical of apocrine IC. A total of 47% of IC harbored a fusion involving RET. In conclusion, we have confirmed the presence of NCOA4-RET as the dominant fusion in intercalated duct type IC. A novel finding in our study has been a discovery of a subset of IC patients with apocrine variant IC harboring a novel TRIM27-RET.

• MeSH
• DNA vazebné proteiny genetika   MeSH
• dospělí MeSH
• fenotyp MeSH
• fúze genů * MeSH
• genetická predispozice k nemoci MeSH
• hybridizace in situ fluorescenční MeSH
• imunohistochemie MeSH
• intraduktální neinfiltrující karcinom chemie   genetika   patologie   MeSH
• jaderné proteiny genetika   MeSH
• koaktivátory jaderných receptorů genetika   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádorové biomarkery analýza   genetika   MeSH
• nádory slinných žláz chemie   genetika   patologie   MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• protoonkogenní proteiny c-ret genetika   MeSH
• registrace MeSH
• sekvenční analýza hybridizací s uspořádaným souborem oligonukleotidů * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stanovení celkové genové exprese přístrojové vybavení   MeSH
• transkriptom MeSH
• vysoce účinné nukleotidové sekvenování MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: We previously confirmed the non-inferiority of accelerated partial breast irradiation (APBI) with interstitial brachytherapy in terms of local control and overall survival compared with whole-breast irradiation for patients with early-stage breast cancer who underwent breast-conserving surgery in a phase 3 randomised trial. Here, we present the 5-year late side-effects and cosmetic results of the trial. METHODS: We did this randomised, controlled, phase 3 trial at 16 centres in seven European countries. Women aged 40 years or older with stage 0-IIA breast cancer who underwent breast-conserving surgery with microscopically clear resection margins of at least 2 mm were randomly assigned 1:1, via an online interface, to receive either whole-breast irradiation of 50 Gy with a tumour-bed boost of 10 Gy or APBI with interstitial brachytherapy. Randomisation was stratified by study centre, menopausal status, and tumour type (invasive carcinoma vs ductal carcinoma in situ), with a block size of ten, according to an automated dynamic algorithm. Patients and investigators were not masked to treatment allocation. The primary endpoint of our initial analysis was ipsilateral local recurrence; here, we report the secondary endpoints of late side-effects and cosmesis. We analysed physician-scored late toxicities and patient-scored and physician-scored cosmetic results from the date of breast-conserving surgery to the date of onset of event. Analysis was done according to treatment received (as-treated population). This trial is registered with ClinicalTrials.gov, number NCT00402519. FINDINGS: Between April 20, 2004, and July 30, 2009, we randomly assigned 1328 women to receive either whole-breast irradiation (n=673) or APBI with interstitial brachytherapy (n=655); 1184 patients comprised the as-treated population (551 in the whole-breast irradiation group and 633 in the APBI group). At a median follow-up of 6·6 years (IQR 5·8-7·6), no patients had any grade 4 toxities, and three (<1%) of 484 patients in the APBI group and seven (2%) of 393 in the whole-breast irradiation group had grade 3 late skin toxicity (p=0·16). No patients in the APBI group and two (<1%) in the whole-breast irradiation group developed grade 3 late subcutaneous tissue toxicity (p=0·10). The cumulative incidence of any late side-effect of grade 2 or worse at 5 years was 27·0% (95% CI 23·0-30·9) in the whole-breast irradiation group versus 23·3% (19·9-26·8) in the APBI group (p=0·12). The cumulative incidence of grade 2-3 late skin toxicity at 5 years was 10·7% (95% CI 8·0-13·4) in the whole-breast irradiation group versus 6·9% (4·8-9·0) in the APBI group (difference -3·8%, 95% CI -7·2 to 0·4; p=0·020). The cumulative risk of grade 2-3 late subcutaneous tissue side-effects at 5 years was 9·7% (95% CI 7·1-12·3) in the whole-breast irradiation group versus 12·0% (9·4-14·7) in the APBI group (difference 2·4%; 95% CI -1·4 to 6·1; p=0·28). The cumulative incidence of grade 2-3 breast pain was 11·9% (95% CI 9·0-14·7) after whole-breast irradiation versus 8·4% (6·1-10·6) after APBI (difference -3·5%; 95% CI -7·1 to 0·1; p=0·074). At 5 years' follow-up, according to the patients' view, 413 (91%) of 454 patients had excellent to good cosmetic results in the whole-breast irradiation group versus 498 (92%) of 541 patients in the APBI group (p=0·62); when judged by the physicians, 408 (90%) of 454 patients and 503 (93%) of 542 patients, respectively, had excellent to good cosmetic results (p=0·12). No treatment-related deaths occurred, but six (15%) of 41 patients (three in each group) died from breast cancer, and 35 (85%) deaths (21 in the whole-breast irradiation group and 14 in the APBI group) were unrelated. INTERPRETATION: 5-year toxicity profiles and cosmetic results were similar in patients treated with breast-conserving surgery followed by either APBI with interstitial brachytherapy or conventional whole-breast irradiation, with significantly fewer grade 2-3 late skin side-effects after APBI with interstitial brachytherapy. These findings provide further clinical evidence for the routine use of interstitial multicatheter brachytherapy-based APBI in the treatment of patients with low-risk breast cancer who opt for breast conservation. FUNDING: German Cancer Aid.

• MeSH
• brachyterapie škodlivé účinky   MeSH
• časové faktory MeSH
• celková dávka radioterapie MeSH
• duktální karcinom prsu patologie   radioterapie   chirurgie   MeSH
• intraduktální neinfiltrující karcinom patologie   radioterapie   chirurgie   MeSH
• kombinovaná terapie MeSH
• kosmetické přípravky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• lobulární karcinom patologie   radioterapie   chirurgie   MeSH
• mastektomie škodlivé účinky   MeSH
• nádory prsu patologie   radioterapie   chirurgie   MeSH
• následné studie MeSH
• prognóza MeSH
• radiodermatitida diagnóza   etiologie   MeSH
• segmentální mastektomie škodlivé účinky   MeSH
• senioři MeSH
• staging nádorů MeSH
• stupeň nádoru MeSH
• tuková nekróza diagnóza   etiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH

Core cut biopsie je nyní nejpoužívanější diagnostickou předoperační metodou u lézí prsu. Na rozdíl od tenkojehlové punkční cytologie, poskytuje core cut biopsie dostatečné množství tkáně pro spolehlivou diagnostiku, umožňuje vyšetření histologické struktury, klasifikaci karcinomu, grading i imunohistochemické vyšetření markerů prediktivní onkologické diagnostiky. Tento přehledový článek popisuje nejčastější diagnostické problémy.

Core cut biopsies are now widely used for non-operative diagnosis of breast lesions. In contrast to fine needle aspiration cytology, core cut biopsy provides sufficient amount of tissue for reliable diagnosis. Histologic structure, classification of carcinoma, grading and markers of predictive oncology can be assesed. The review article deals with some commonly encountered diagnostic problems.

• Klíčová slova
• punkční biopsie, atypická duktální hyperplazie,
• MeSH
• biopsie dutou jehlou MeSH
• duktální karcinom prsu diagnóza   patologie   MeSH
• hyperplazie diagnóza   patologie   MeSH
• imunohistochemie MeSH
• intraduktální neinfiltrující karcinom diagnóza   patologie   MeSH
• jehlová biopsie * MeSH
• karcinom in situ diagnóza   patologie   MeSH
• lidé MeSH
• mléčné žlázy lidské patologie   MeSH
• nádorové biomarkery MeSH
• nádory prsu * diagnóza   patologie   MeSH
• papilární karcinom diagnóza   patologie   MeSH
• proliferace buněk MeSH
• prsy patologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

OBJECTIVES: The aim of the study was to develop a clinical prediction model for assessing the probability of having invasive cancer in the definitive surgical resection specimen in patients with biopsy diagnosis of ductal carcinoma in situ (DCIS) of the breast, to facilitate decision making regarding axillary surgery. METHODS: In 349 women with DCIS, predictors of invasion in the definitive resection specimen were identified. A model to predict the probability of invasion was developed and subsequently simplified to divide patients into two risk categories. The model's performance was validated on another patient population. RESULTS: Multivariate logistic regression revealed four independent predictors of invasion: (i) suspicious (micro)invasion in the biopsy specimen; (ii) visibility of the lesion on ultrasonography; (iii) size of the lesion on mammography>30 mm; (iv) clinical palpability of the lesion. The actual frequency of invasion in the high-risk patient group in the test and validation population was 52.6% and 48.3%, respectively; in the low-risk group it was 16.8% and 7.1%, respectively. CONCLUSION: The model proved to have good performance. In patients with a low probability of invasion, an axillary procedure can be omitted without a substantial risk of additional surgery.

• MeSH
• intraduktální neinfiltrující karcinom epidemiologie   patologie   ultrasonografie   MeSH
• jehlová biopsie škodlivé účinky   statistika a číselné údaje   MeSH
• lidé MeSH
• nádory prsu epidemiologie   patologie   MeSH
• riziko MeSH
• statistické modely MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH