{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:40:03Z","timestamp":1762101603217},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,1,21]],"date-time":"2015-01-21T00:00:00Z","timestamp":1421798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to examine clinicopathological features of patients with core biopsy diagnoses of ductal carcinoma <jats:italic>in situ<\/jats:italic> (<jats:styled-content style=\"fixed-case\">DCIS<\/jats:styled-content>) that may predict invasion on subsequent excision, as upstaging has significant implications regarding the need for axillary staging via sentinel lymph node biopsy (<jats:styled-content style=\"fixed-case\">SLNB<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We identified 186 patients with a diagnosis of <jats:styled-content style=\"fixed-case\">DCIS<\/jats:styled-content> as the highest\u2010stage lesion on core biopsy. Pathological and clinical features were assessed via slide and chart review, respectively. Distorting sclerosis was defined as irregular angulation of glands involved by <jats:styled-content style=\"fixed-case\">DCIS<\/jats:styled-content> but lacking definite invasion according to histology and\/or immunohistochemical staining for myoepithelial markers. Thirty\u2010two of 186 (17.2%) cases had upstaging to either microinvasive (nine) or invasive (23) ductal carcinoma. <jats:styled-content style=\"fixed-case\">SLNB<\/jats:styled-content> was performed in 29 of 32 (90.6%) cases with upstaging and in 55 of 154 (35.7%) cases without (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). Upstaging was significantly associated with the presurgical variables of radiological mass (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.009) and distorting sclerosis (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0005) and the postsurgical feature of multifocality (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sentinel lymph node biopsy is frequently performed for patients with upstaging from <jats:styled-content style=\"fixed-case\">DCIS<\/jats:styled-content> on core biopsy to microinvasive or invasive carcinoma on excision. <jats:styled-content style=\"fixed-case\">DCIS<\/jats:styled-content> with distorting sclerosis without definite invasion on core biopsy may be predictive of upstaging. This feature may be useful in selecting patients to undergo <jats:styled-content style=\"fixed-case\">SLNB<\/jats:styled-content> at the time of excision to avoid reoperation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.12550","type":"journal-article","created":{"date-parts":[[2014,9,17]],"date-time":"2014-09-17T18:35:10Z","timestamp":1410978910000},"page":"577-586","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Ductal carcinoma <i>in situ<\/i> with distorting sclerosis on core biopsy may be predictive of upstaging on excision"],"prefix":"10.1111","volume":"66","author":[{"given":"Laura L","family":"Walters","sequence":"first","affiliation":[{"name":"Department of Pathology University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy C","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M","family":"Jorns","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,1,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.05.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1015-9584(10)60013-9"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0077826"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20445"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2013.12.002"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9337"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4741.2011.01069.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-1438-9"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22216"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2010.243"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2010.08.005"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2010.09.032"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23273"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.5858\/2002-126-0039-PIITES","article-title":"Predicting invasion in the excision specimen from breast core needle biopsy specimens with only ductal carcinoma in\u00a0situ","volume":"126","author":"Renshaw AA","year":"2002","journal-title":"Arch. 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