Evidence map›Paper›PMID 36804000›Full record

ArticleWorld journal of surgical oncology2023

High rate of postoperative upstaging of ductal carcinoma in situ when prioritizing ultrasound evaluation of mammography-detected lesions: a single-center retrospective cohort study.

Yung-Chun Hsieh, Chiao Lo, Yi-Hsuan Lee, Ning Chien, Tzu-Pin Lu, Li-Wei Tsai, Ming-Yang Wang, Wen-Hung Kuo, Yeun-Chung Chang, Chiun-Sheng Huang

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Yung-Chun HsiehNational Taiwan University College of Medicine, Taipei, Taiwan.
Chiao LoNational Taiwan University College of Medicine, Taipei, Taiwan.
Yi-Hsuan LeeNational Taiwan University College of Medicine, Taipei, Taiwan.
Ning ChienNational Taiwan University College of Medicine, Taipei, Taiwan.
Tzu-Pin LuDepartment of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan.
Li-Wei TsaiDepartment of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Ming-Yang WangDepartment of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Wen-Hung KuoDepartment of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Yeun-Chung ChangDepartment of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Chiun-Sheng HuangNational Taiwan University College of Medicine, Taipei, Taiwan. huangcs@ntu.edu.tw.
National Taiwan University · TWNational Taiwan University Hospital · TWNational Yang Ming Chiao Tung University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe initial diagnosis of ductal carcinoma in situ (DCIS) can be upstaged to invasive cancer after definitive surgery. This study aimed to identify risk factors for DCIS upstaging using routine breast ultrasonography and mammography (MG) and to propose a prediction model.

methodsIn this single-center retrospective study, patients initially diagnosed with DCIS (January 2016-December 2017) were enrolled (final sample size = 272 lesions). Diagnostic modalities included ultrasound-guided core needle biopsy (US-CNB), MG-guided vacuum-assisted breast biopsy, and wire-localized surgical biopsy. Breast ultrasonography was routinely performed for all patients. US-CNB was prioritized for lesions visible on ultrasound. Lesions initially diagnosed as DCIS on biopsy with a final diagnosis of invasive cancer at definitive surgery were defined as "upstaged."

resultsThe postoperative upstaging rates were 70.5%, 9.7%, and 4.8% in the US-CNB, MG-guided vacuum-assisted breast biopsy, and wire-localized surgical biopsy groups, respectively. US-CNB, ultrasonographic lesion size, and high-grade DCIS were independent predictive factors for postoperative upstaging, which were used to construct a logistic regression model. Receiver operating characteristic analysis showed good internal validation (area under the curve = 0.88).

conclusionsSupplemental screening breast ultrasonography possibly contributes to lesion stratification. The low upstaging rate for ultrasound-invisible DCIS diagnosed by MG-guided procedures suggests that it is unnecessary to perform sentinel lymph node biopsy for lesions invisible on ultrasound. Case-by-case evaluation of DCIS detected by US-CNB can help surgeons determine if repeating biopsy with vacuum-assisted breast biopsy is necessary or if sentinel lymph node biopsy should accompany breast-preserving surgery.

trial registrationThis single-center retrospective cohort study was conducted with the approval of the institutional review board of our hospital (approval number 201610005RIND). As this was a retrospective review of clinical data, it was not registered prospectively.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, Intraductal, NoninfiltratingBiopsy, Large-Core NeedleFemaleHumansMammographyRetrospective StudiesBreast cancerDuctal carcinoma in situMammographySentinel lymph node biopsyUltrasonography

Identifiers

PMID36804000
PMCPMC9936646
OpenAlexW4321234729

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.