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Prospective Multicenter Study Validate a Prediction Model for Surgery Uptake Among Women with Atypical Breast Lesions.
Uzan, Catherine; Mazouni, Chafika; Rossoni, Caroline; De Korvin, Brigitte; de Lara, Christine Tunon; Cohen, Monique; Chabbert, Nathalie; Zilberman, Sonia; Boussion, Veronique; Vincent Salomon, Anne; Espie, Marc; Coutant, Charles; Marchal, Frederic; Salviat, Flore; Boulanger, Loic; Doutriaux-Dumoulin, Isabelle; Jouve, Eva; Mathelin, Carole; de Saint Hilaire, Pierre; Mollard, Joelle; Balleyguier, Corinne; Joyon, Natacha; Triki, Magali Lacroix; Delaloge, Suzette; Michiels, Stefan.
Afiliación
  • Uzan C; AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière University Hospital, Paris, France. catherine.uzan@aphp.fr.
  • Mazouni C; Sorbonne University, INSERM UMR_S_938, "Cancer Biology and Therapeutics", Centre de Recherche Saint-Antoine (CRSA), Paris, France. catherine.uzan@aphp.fr.
  • Rossoni C; Institut Universitaire de Cancérologie (IUC), Paris, France. catherine.uzan@aphp.fr.
  • De Korvin B; Gustave Roussy, Villejuif, France.
  • de Lara CT; Gustave Roussy, Villejuif, France.
  • Cohen M; Radiology Center, Centre Eugène Marquis, CHU Rennes, Rennes, France.
  • Chabbert N; Institut Bergonié, Bordeaux, France.
  • Zilberman S; Institut Paoli Calmettes, Marseille, France.
  • Boussion V; Hôpital Tenon, Sorbonne University, Paris, France.
  • Vincent Salomon A; Hôpital Tenon, Sorbonne University, Paris, France.
  • Espie M; Centre Jean Perrin, Clermont-Ferrand, France.
  • Coutant C; Institut Curie, Université Paris-Sciences Lettres, INSERM U934, Département de Médecine Diagnostique et Théranostique, Paris, France.
  • Marchal F; University of Paris, Hôpital Saint Louis, APHP, Paris, France.
  • Salviat F; Centre Georges François Leclerc, Dijon, France.
  • Boulanger L; Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
  • Doutriaux-Dumoulin I; Service de Biostatistique et d'Épidémiologie, Gustave Roussy, Villejuif, France.
  • Jouve E; CESP INSERM U1018, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.
  • Mathelin C; Centre Oscar Lambret, Lille, France.
  • de Saint Hilaire P; Institut Cancérologique de l'ouest, Saint-Herblain, France.
  • Mollard J; Institut Claudius Regaud-Oncopole, Toulouse, France.
  • Balleyguier C; Les Hôpitaux universitaires de Strasbourg, Strasbourg, France.
  • Joyon N; Hôpital de la Croix-Rousse, Lyon, France.
  • Triki ML; CHU Dupuytren, Limoges, France.
  • Delaloge S; Gustave Roussy, Villejuif, France.
  • Michiels S; Gustave Roussy, Villejuif, France.
Ann Surg Oncol ; 28(4): 2138-2145, 2021 Apr.
Article en En | MEDLINE | ID: mdl-32920723
BACKGROUND: Diagnosis of atypical breast lesions (ABLs) leads to unnecessary surgery in 75-90% of women. We have previously developed a model including age, complete radiological target excision after biopsy, and focus size that predicts the probability of cancer at surgery. The present study aimed to validate this model in a prospective multicenter setting. - METHODS: Women with a recently diagnosed ABL on image-guided biopsy were recruited in 18 centers, before wire-guided localized excisional lumpectomy. Primary outcome was the negative predictive value (NPV) of the model. RESULTS: The NOMAT model could be used in 287 of the 300 patients included (195 with ADH). At surgery, 12 invasive (all grade 1), and 43 in situ carcinomas were identified (all ABL: 55/287, 19%; ADH only: 49/195, 25%). The area under the receiving operating characteristics curve of the model was 0.64 (95% CI 0.58-0.69) for all ABL, and 0.63 for ADH only (95% CI 0.56-0.70). For the pre-specified threshold of 20% predicted probability of cancer, NPV was 82% (77-87%) for all ABL, and 77% (95% CI 71-83%) for patients with ADH. At a 10% threshold, NPV was 89% (84-94%) for all ABL, and 85% (95% CI 78--92%) for the ADH. At this threshold, 58% of the whole ABL population (and 54% of ADH patients) could have avoided surgery with only 2 missed invasive cancers. CONCLUSION: The NOMAT model could be useful to avoid unnecessary surgery among women with ABL, including for patients with ADH. CLINICAL TRIAL REGISTRATION: NCT02523612.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Carcinoma in Situ / Carcinoma Ductal de Mama / Carcinoma Intraductal no Infiltrante Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Carcinoma in Situ / Carcinoma Ductal de Mama / Carcinoma Intraductal no Infiltrante Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos