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Table 3 Predictors of patients’ selection for breast conserving surgery, mastectomy, and axillary lymph node surgery

From: Revisit the practice of lymph node biopsy in patients diagnosed as ductal carcinoma in situ before operation: a retrospective analysis of 682 cases and evaluation of the role of breast MRI

  Total mastectomy versus partial mastectomy (BCS) Lymph node surgery versus no surgery
Pre-OP DCIS (N = 682) Total mastectomy
N = 430
Partial mastectomy
N = 252
P value No LN surgery
N = 62
With LN surgery
N = 620
P value
Age, year 51.9 ± 9.9 53.1 ± 10.5 0.14 54 ± 12.2 52.2 ± 9.9 0.17
Location    0.33    0.31
Right 213(49.5) 115(45.6)   26(41.9) 302(48.7)  
Left 217(50.5) 137(54.4)   36(58.1) 318(51.3)  
Biopsy method N/A = 3 N/A = 0  < 0.01 N/A = 0 N/A = 3  < 0.01
CNB 298(69.8) 123(48.8)   19(30.6) 402(65.2)  
Stereotactic biopsy 84(19.7) 83(32.9)   23(37.1) 144(23.3)  
Excisional biopsy 43(10.1) 45(17.9)   18(29) 70(11.3)  
MMG 2(0.5) 1(0.4)   2(3.2) 1(0.2)  
Sonogram tumor size, cm 2.2 ± 1.2 1.6 ± 0.8  < 0.01 1.7 ± 1.4 2 ± 1.1 0.11
Mammogram tumor size, cm 2.9 ± 1.3 2.0 ± 0.9  < 0.01 1.6 ± 0.4 2.6 ± 1.2 0.10
MRI tumor size, cm 4.5 ± 2.3 2.8 ± 1.4  < 0.01 2.7 ± 1.7 4 ± 2.2  < 0.01
Pathology tumor sizea, cm (cm) 2.6 ± 2.9 1.7 ± 1.6  < 0.01 1.8 ± 1.7 2.3 ± 2.6 0.22
Gross tumor size, cmb
(invasive + non-invasive)
4 ± 2.6 2.2 ± 1.4  < 0.01 2.6 ± 1.8 3.5 ± 2.4 0.04
Stage N/A = 11 N/A = 22  < 0.01 N/A = 12 N/A = 21 0.03
0 226(53.9) 164(71.3)   40(80) 350(58.4)  
I 130(31) 53(23)   8(16) 175(29.2)  
II 54(12.9) 11(4.8)   2(4) 63(10.5)  
III 9(2.1) 2(0.9)   0(0) 11(1.8)  
Grade N/A = 38 N/A = 36  < 0.01 N/A = 19 N/A = 55 0.14
I 39(9.9) 37(17.1)   6(14.0) 70(12.4)  
II 215(54.8) 122(56.5)   29(67.4) 308(54.5)  
III 138(35.2) 57(26.4)   8(18.6) 187(33.1)  
ER N/A = 9 N/A = 15  < 0.01 N/A = 11 N/A = 13 0.25
Positive 293(69.6) 191(80.6)   41(80.4) 443(73.0)  
Negative 128(30.4) 46(19.4)   10(19.6) 164(27.0)  
PR N/A = 13 N/A = 20  < 0.01 N/A = 11 N/A = 22 0.15
Positive 259(62.1) 179(77.2)   39(76.5) 399(66.7)  
Negative 158(37.9) 53(22.8)   12(23.5) 199(33.3)  
HER-2(N/A = 203) N/A = 121 N/A = 82 0.53 N/A = 29 N/A = 174 0.64
Positive 118(38.2) 60(35.3)   11(33.3) 167(37.4)  
Negative 191(61.8) 110(64.7)   22(66.7) 279(62.6)  
Subtype N/A = 68 N/A = 52  < 0.01 N/A = 24 N/A = 96 0.17
Luminal A 198(54.7) 133(66.5)   27(71.1) 304(58.0)  
Luminal B1 23(6.4) 11(5.5)   2(5.3) 32(6.1)  
Luminal B2 50(13.8) 32(16.0)   7(18.4) 75(14.3)  
HER-2( +) 56(15.5) 15(7.5)   2(5.3) 69(13.2)  
TNBC 35(9.7) 9(4.5)   0(0) 44(8.4)  
Post-OP pathology     < 0.01     < 0.01
DCIS 255(59.3) 194(77)   52(83.9) 397(64)  
Upgrade 175(40.7) 58(23)   10(16.1) 223(36)  
Ki-67 N/A = 313 N/A = 221  < 0.01 N/A = 57 N/A = 477 0.92
20 67(57.3) 25(80.6)   3(60) 89(62.2)  
 > 20 50(42.7) 6(19.4))   2(40) 54(37.8)  
MRI LN metastasis NA = 166 N/A = 109  < 0.05 NA = 28 N/A = 247 0.10
Yes 69(26.1) 25(17.5)   30(88.2) 90(24.1)  
No 195(73.9) 118(82.5)   4(11.8) 283(75.9)  
Lymph node stage N/A = 60 N/A = 23  < 0.01 N/A = 15 N/A = 68 0.20
N0 327(88.4) 222(96.9)   47(100) 502(90.9)  
N1 35(9.5) 5(2.2))   0(0) 40(7.2)  
N2 6(1.6) 1(0.4)   0(0) 7(1.3)  
N3 2(0.5) 1(0.4)   0(0) 3(0.5)  
LN metastasis N/A = 8 N/A = 25  < 0.01 N/A = 29 N/A = 4 0.09
Yes 42(10) 7(3.1)   0(0) 49(8)  
No 380(90) 220(96.9)   33(100) 567(92)  
OP method     < 0.01
Total 16(25.8) 414(66.8)  
Partial 46(74.2) 206(33.2)  
Method LN     < 0.01
SLNB 350(81.4) 178(70.6)  
SLNB + ALND 31(7.2) 18(7.1)  
ALND 33(7.7) 10(4)  
ND 16(3.7) 46(18.3)  
  1. MMG mammography guided biopsy, LN lymph node, SLNB sentinel lymph node biopsy, ALND axillary lymph node dissection, ND not done, OP operation, DCIS ductal carcinoma in situ, TNBC triple negative breast cancer, ER estrogen receptor, PR progesterone receptor, HER-2 human epithelial grow receptor type 2, N/A not available
  2. aPathology tumor size: in pure DCIS cases pathologic tumor size=DCIS tumor size, if containing invasive component then pathologic tumor size=invasive cancer tumor size
  3. bGross tumor size: invasive + non-invasive component tumor size