Department of Surgical Oncology, Rene Huguenin, Saint-Cloud, France
Department of Gynecology and Obstetrics, Lariboisiere Hospital, Paris, France.
Anticancer Res. 2020 Feb;40(2):1095-1100. doi: 10.21873/anticanres.14048.
BACKGROUND/AIM: Fibroepithelial lesions (FEL) of the breast include fibroadenomas and phyllodes tumors (PT). Their histologic characteristics on core needle biopsy can overlap, while their clinical management is different. The aim of this study was to develop and to validate a pre-operative score for the diagnosis of PT with surgical decision rules.
We developed a pre-operative score for the diagnosis of PT by performing logistic regression on 217 FEL of the Rene Huguenin Hospital. This score and the surgical decision rules were validated on 87 FEL of the Lariboisiere Hospital.
Three variables were independently and significantly associated with PT: age ≥40 years, mammography's tumor size ≥3 cm and PT diagnosed by CNB. The pre-operative score was based on these three criteria with values ranging from 0 to 10. Surgical decision rules were created: the low-risk group of PT (score≤2) had a sensitivity of 92.6% and a LR- of 0.2, the high-risk group (score>7) had a specificity of 93.5% and a LR+ of 4.4. In the validation sample, surgical decision rules were applied.
These surgical decision rules may prove useful in deciding which FEL needs surgical resection.
背景/目的：乳腺纤维上皮性病变（FEL）包括纤维腺瘤和叶状肿瘤（PT）。它们在核心针活检中的组织学特征可能重叠，而其临床管理则不同。本研究的目的是开发和验证术前评分，以用于具有手术决策规则的 PT 诊断。
我们通过对 Rene Huguenin 医院的 217 例 FEL 进行逻辑回归，制定了用于诊断 PT 的术前评分。该评分和手术决策规则在 Lariboisiere 医院的 87 例 FEL 中得到验证。
三个变量与 PT 独立且显著相关：年龄≥40 岁、乳房 X 线摄影的肿瘤大小≥3cm 和 CNB 诊断为 PT。术前评分基于这三个标准，分值范围为 0 至 10。创建了手术决策规则：PT 的低危组（评分≤2）的敏感度为 92.6%，LR-为 0.2；高危组（评分>7）的特异度为 93.5%，LR+为 4.4。在验证样本中，应用了手术决策规则。
这些手术决策规则可能有助于决定哪些 FEL 需要手术切除。
