Ultrasound characteristics comparison and development of a predictive nomogram for intraductal papilloma and ductal carcinoma

Background: Intraductal Papilloma (IDP) and Ductal Carcinoma Methods: Conducted at Quanzhou First Hospital over a three-year period, 389 patients were enrolled with detailed ultrasound examinations and confirmed pathological diagnoses. IDP was classified into Grades 3, 4, and 5, whereas DCIS presented with a mass-like morphology. Patients meeting the inclusion criteria underwent rigorous analysis, with exclusion criteria eliminating those with incomplete imaging data or confounding comorbidities. Ultrasound characteristics, including lesion size, shape, margin, and echogenicity, etc., were systematically evaluated and compared between the two groups. Univariate and multivariate logistic regression analyses were conducted to identify significant risk factors. Subsequently, based on these characteristics, both static and dynamic nomograms were developed. The performance of the nomograms was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA). Results: The study cohort included 272 patients in the training set and 117 in the validation set. Significant differences were observed between IDP and DCIS in age, size, shape, aspect ratio, margin, duct dilatation, and microcalcification ( Conclusion: The nomogram incorporating key predictors provides a valuable tool for differentiating between IDP and DCIS based on ultrasound characteristics. This approach aids in clinical decision-making and potentially reduces unnecessary biopsies.