Prediction of Microinvasion in Breast Ductal Carcinoma in Situ Using Conventional Ultrasound Combined with Contrast-Enhanced Ultrasound Features: A Two-Center Study

Tingting Wu ¹, Jing Chen ², Sihui Shao ²

⁰Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai, China; Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Clinical Breast Cancer +

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October 20, 2024

View abstract on PubMed

Summary

A new model using conventional and contrast-enhanced ultrasound accurately predicts microinvasion in ductal carcinoma in situ (DCIS), aiding preoperative diagnosis. This tool helps identify invasive breast cancer before surgery.

Area Of Science

Radiology
Oncology
Medical Imaging

Background

Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer.
Microinvasion in DCIS can alter treatment strategies.
Accurate preoperative prediction of microinvasion is crucial.

Purpose Of The Study

To develop and validate a predictive model for microinvasion in DCIS.
Utilize conventional ultrasound (CUS) and contrast-enhanced ultrasound (CEUS) features.
Improve preoperative diagnostic accuracy.

Main Methods

Retrospective analysis of 163 DCIS patients from an internal hospital and 56 from an external hospital.
Development of a predictive model using logistic regression on CUS and CEUS features.
Validation of the model's calibration, discrimination, and clinical utility.

Main Results

Centripetal enhancement direction, enlarged enhancement range on CEUS, lesion size ≥20 mm, and calcification on CUS were independent predictors.
The developed nomogram demonstrated high discrimination (AUCs 0.850-0.879) and good calibration.
The nomogram outperformed standalone CUS and CEUS models and was clinically useful.

Conclusions

A nomogram integrating CUS and CEUS features shows significant potential for preoperative microinvasion prediction in DCIS.
This model can aid in surgical planning and patient management.
Further validation in diverse populations is warranted.

Keywords:

Breast ductal carcinoma in situ Contrast-enhanced ultrasound Conventional ultrasound Microinvasion Nomogram