TY - JOUR
T1 - Predicting invasive breast cancer versus DCIS in different age groups
AU - Ayvaci, Mehmet U.S.
AU - Alagoz, Oguzhan
AU - Chhatwal, Jagpreet
AU - Munoz del Rio, Alejandro
AU - Sickles, Edward A.
AU - Nassif, Houssam
AU - Kerlikowske, Karla
AU - Burnside, Elizabeth S.
N1 - Publisher Copyright:
© 2014 Ayvaci et al.; licensee BioMed Central Ltd.
PY - 2014/8/11
Y1 - 2014/8/11
N2 - Background: Increasing focus on potentially unnecessary diagnosis and treatment of certain breast cancers prompted our investigation of whether clinical and mammographic features predictive of invasive breast cancer versus ductal carcinoma in situ (DCIS) differ by age.Methods: We analyzed 1,475 malignant breast biopsies, 1,063 invasive and 412 DCIS, from 35,871 prospectively collected consecutive diagnostic mammograms interpreted at University of California, San Francisco between 1/6/1997 and 6/29/2007. We constructed three logistic regression models to predict the probability of invasive cancer versus DCIS for the following groups: women ≥ 65 (older group), women 50-64 (middle age group), and women < 50 (younger group). We identified significant predictors and measured the performance in all models using area under the receiver operating characteristic curve (AUC).Results: The models for older and the middle age groups performed significantly better than the model for younger group (AUC = 0.848 vs, 0.778; p = 0.049 and AUC = 0.851 vs, 0.778; p = 0.022, respectively). Palpability and principal mammographic finding were significant predictors in distinguishing invasive from DCIS in all age groups. Family history of breast cancer, mass shape and mass margins were significant positive predictors of invasive cancer in the older group whereas calcification distribution was a negative predictor of invasive cancer (i.e. predicted DCIS). In the middle age group-mass margins, and in the younger group-mass size were positive predictors of invasive cancer.Conclusions: Clinical and mammographic finding features predict invasive breast cancer versus DCIS better in older women than younger women. Specific predictive variables differ based on age.
AB - Background: Increasing focus on potentially unnecessary diagnosis and treatment of certain breast cancers prompted our investigation of whether clinical and mammographic features predictive of invasive breast cancer versus ductal carcinoma in situ (DCIS) differ by age.Methods: We analyzed 1,475 malignant breast biopsies, 1,063 invasive and 412 DCIS, from 35,871 prospectively collected consecutive diagnostic mammograms interpreted at University of California, San Francisco between 1/6/1997 and 6/29/2007. We constructed three logistic regression models to predict the probability of invasive cancer versus DCIS for the following groups: women ≥ 65 (older group), women 50-64 (middle age group), and women < 50 (younger group). We identified significant predictors and measured the performance in all models using area under the receiver operating characteristic curve (AUC).Results: The models for older and the middle age groups performed significantly better than the model for younger group (AUC = 0.848 vs, 0.778; p = 0.049 and AUC = 0.851 vs, 0.778; p = 0.022, respectively). Palpability and principal mammographic finding were significant predictors in distinguishing invasive from DCIS in all age groups. Family history of breast cancer, mass shape and mass margins were significant positive predictors of invasive cancer in the older group whereas calcification distribution was a negative predictor of invasive cancer (i.e. predicted DCIS). In the middle age group-mass margins, and in the younger group-mass size were positive predictors of invasive cancer.Conclusions: Clinical and mammographic finding features predict invasive breast cancer versus DCIS better in older women than younger women. Specific predictive variables differ based on age.
KW - Aging
KW - Biopsy
KW - Breast neoplasms
KW - Logistic models
KW - Mammography
KW - Overdiagnosis
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U2 - 10.1186/1471-2407-14-584
DO - 10.1186/1471-2407-14-584
M3 - Article
C2 - 25112586
AN - SCOPUS:84908220949
SN - 1471-2407
VL - 14
JO - BMC cancer
JF - BMC cancer
IS - 1
M1 - 584
ER -