Table 2 Upgrade rate, adequacy of surgical lymph node biopsy, and rate of lymph node metastasis in patients diagnosed as ductal carcinoma in situ before operation
Upgrade ratio versus operation method | |||||
| Â | BCS | Mastectomy | Total | P value | Â |
DCIS | 194 | 255 | 449(65.8%) | <0.01 | Â |
DCIS-IC | 58 | 175 | 233(34.2%) | Â | |
Total | 252 (37%) | 430 (63%) | 682 | Â | |
Post-OP pathology and lymph node surgery | |||||
Post-OP pathology | DCIS | DCIS-IC | Total | P value | Â |
Axillary surgery | |||||
ALN biopsy/dissection | 397(58.2%) over treatment | 223(32.7%) adequate treatment | 620 | 0.01 | Â |
No axillary surgery | 52(7.6%) adequate treatment | 10(1.5%) under-treatment | 62 | Â | Â |
Total | 449 | 233 | 682(100%) | Â | Â |
Pathology and lymph node metastasis distribution | |||||
| Â | Pre-OP DCIS N=682 | Pure-DCIS N=449 | DCIS-IC N=233 | Pre-OP invasive cancer N=2268 | P value |
No LN metastasis | 92.4% (600/649) | 99.2% (394/397) | 79.4% (177/223) | 61% (1385/2268) | <0.01 |
LN metastasis | 7.6% (49/649) | 0.8% (3/397) | 20.6% (46/223) | 39% (883/2268) | Â |
No axilla surgery | N=33 | N=52 | N=10 | N=0 | Â |
N1 | 0 | 1 ITC, 1micro-metastasis | 80.4% (37/46) | 68% (600/883) | Â |
N2 | 0 | 0 | 15.2% (7/46) | 21.9% (193/883) | Â |
N3 | 0 | 1 | 4.3% (2/46) | 10.2% (90/883) | Â |
Breast MRI lymph node metastasis evaluation | |||||
| Â | MRI predict LN metastasis | MRI predict LN negative | Total | ||
Pathology LN metastasis | 14 | 12 | 26 | ||
Pathology LN negative | 80 | 280 | 360 | ||
Total | 94 | 292 | 386 | ||
Sensitivity=14/26=53.8% | |||||
Specificity=280/360=77.8% | |||||
Positive predictive value (PPV)=14/94=14.9% | |||||
Negative predictive value (NPV)=280/292=95.9% | |||||
Accuracy= (14+280)/386 =76.2% | |||||