The predictive value of calcification for the grading of ductal carcinoma in situ in Chinese patients

Abstract

High-grade ductal carcinoma in situ (DCIS) requires resection due to the high risk of developing invasive breast cancer. The predictive powers of noninvasive predictors for high-grade DCIS remain contradictory. This study aimed to explore the predictive value of calcification for high-grade DCIS in Chinese patients. This was a retrospective study of Chinese DCIS patients recruited from the Women's Hospital, School of Medicine, Zhejiang University between January and December 2018. The patients were divided into calcification and non-calcification groups based on the mammography results. The correlation of calcification with the pathologic stage of DCIS was evaluated using the multivariable analysis. The predictive value of calcification for DCIS grading was examined using the receiver operating characteristics (ROC) curve. The pathologic grade of DCIS was not associated with calcification morphology ( P = .902), calcification distribution ( P = .252), or breast density ( P = .188). The multivariable analysis showed that the presence of calcification was independently associated with high pathologic grade of DCIS (OR = 3.206, 95% CI = 1.315–7.817, P = .010), whereas the age, hypertension, menopause, and mammography BI-RADS were not (all P > .05) associated with the grade of DCIS. The ROC analysis of the predictive value of calcification for DCIS grading showed that the area under the curve was 0.626 ( P = .019), with a sensitivity of 73.1%, specificity of 52.2%, positive predictive value of 72.2%, and negative predictive value of 53.3%. The presence of calcification is independently associated with high pathologic grade of DCIS and could predict high-grade DCIS in Chinese patients.

MiRNA expression deregulation correlates with the Oncotype DX® DCIS score

“…This heterogeneous group of neoplastic lesions, which is considered a precursor to invasive ductal carcinoma (IDC), accounts for approximately 20% of newly diagnosed breast cancer cases in the USA [4] with incidence peaking in women aged 65-69 years. Clinically, DCIS is commonly detected through routine screening mammograms, and often presents as microcalcifications (approximately 80-90% of DCIS cases) [5] and less often as a palpable mass (approximately 8% of cases) [6,7]. Advancements in screening mammography coupled with additional diagnostic mammography, ultrasound, and/ or breast MRI for patients who present with a suspicious lesion are not only important for the characterization of ipsilateral disease [8][9][10] but have also greatly increased the detection of DCIS lesions [11].…”