A Pre-operative Score to Discriminate Fibroepithelial Lesions of the Breast: Phyllode Tumor or Fibroadenoma?
Adult
Biopsy, Large-Core Needle
Breast
/ pathology
Breast Neoplasms
/ diagnosis
Clinical Decision-Making
Diagnosis, Differential
Disease Management
Female
Fibroadenoma
/ diagnosis
Humans
Mammography
Middle Aged
Neoplasms, Fibroepithelial
/ diagnosis
Phyllodes Tumor
/ diagnosis
ROC Curve
Retrospective Studies
Young Adult
Fibroepithelial lesions
fibroadenoma
phyllodes tumors
score
Journal
Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
14
12
2019
revised:
19
12
2019
accepted:
30
12
2019
entrez:
5
2
2020
pubmed:
6
2
2020
medline:
20
2
2020
Statut:
ppublish
Résumé
Fibroepithelial lesions (FEL) of the breast include fibroadenomas and phyllodes tumors (PT). Their histologic characteristics on core needle biopsy can overlap, while their clinical management is different. The aim of this study was to develop and to validate a pre-operative score for the diagnosis of PT with surgical decision rules. We developed a pre-operative score for the diagnosis of PT by performing logistic regression on 217 FEL of the Rene Huguenin Hospital. This score and the surgical decision rules were validated on 87 FEL of the Lariboisiere Hospital. Three variables were independently and significantly associated with PT: age ≥40 years, mammography's tumor size ≥3 cm and PT diagnosed by CNB. The pre-operative score was based on these three criteria with values ranging from 0 to 10. Surgical decision rules were created: the low-risk group of PT (score≤2) had a sensitivity of 92.6% and a LR- of 0.2, the high-risk group (score>7) had a specificity of 93.5% and a LR+ of 4.4. In the validation sample, surgical decision rules were applied. These surgical decision rules may prove useful in deciding which FEL needs surgical resection.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Fibroepithelial lesions (FEL) of the breast include fibroadenomas and phyllodes tumors (PT). Their histologic characteristics on core needle biopsy can overlap, while their clinical management is different. The aim of this study was to develop and to validate a pre-operative score for the diagnosis of PT with surgical decision rules.
PATIENTS AND METHODS
METHODS
We developed a pre-operative score for the diagnosis of PT by performing logistic regression on 217 FEL of the Rene Huguenin Hospital. This score and the surgical decision rules were validated on 87 FEL of the Lariboisiere Hospital.
RESULTS
RESULTS
Three variables were independently and significantly associated with PT: age ≥40 years, mammography's tumor size ≥3 cm and PT diagnosed by CNB. The pre-operative score was based on these three criteria with values ranging from 0 to 10. Surgical decision rules were created: the low-risk group of PT (score≤2) had a sensitivity of 92.6% and a LR- of 0.2, the high-risk group (score>7) had a specificity of 93.5% and a LR+ of 4.4. In the validation sample, surgical decision rules were applied.
CONCLUSION
CONCLUSIONS
These surgical decision rules may prove useful in deciding which FEL needs surgical resection.
Identifiants
pubmed: 32014959
pii: 40/2/1095
doi: 10.21873/anticanres.14048
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1095-1100Informations de copyright
Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.