Receiver-operating characteristic curve determined by multivariate logistic regression analysis for distinguishing high recurrence scores from low or intermediate recurrence scores: parallel orientation, tumour roundness, lymphovascular invasion, PR negativity, and high Ki-67 are predictors of recurrence.

<p>Data in parentheses indicate the A_z values for the each variables.</p

Multivariate analysis of factors associated with high recurrence scores.

<p>Multivariate analysis of factors associated with high recurrence scores.</p

Correlation between the tumour roundness and recurrence score.

<p>The correlation plot shows a positive relationship between the tumour roundness and recurrence score (r = 0.349).</p

Receiver-operating characteristic curve determined by multivariate logistic regression analysis for distinguishing low recurrence scores from high or intermediate recurrence scores: tumour roundness, absence of calcification in the mass, lymphovascular invasion, PR positivity, nuclear grade, and p53 are predictors of recurrence.

<p>Data in parentheses indicate the A_z values for the each variables.</p

Multivariate analysis of factors associated with low recurrence scores.

<p>Multivariate analysis of factors associated with low recurrence scores.</p

Association between US features and recurrence scores by univariate analysis.

<p>Association between US features and recurrence scores by univariate analysis.</p

A 38-year-old woman with a recurrence score of 34 (i.e., high risk).

<p>US images (A and B) showing an oval-shaped hypoechoic mass with parallel orientation, circumscribed margins, and calcification in the mass (tumour roundness score = 57.45). Surgery confirmed invasive ductal carcinoma with lymphovascular invasion. The immunohistochemistry tests demonstrated PR negativity, HER2 negativity, and a Ki-67 index of 15%.</p

A 63-year-old woman with a recurrence score of 13 (i.e., low risk).

<p>US images (A and B) showing an irregularly shaped, hypoechoic mass (arrows) with spiculated margins that is not parallel to the skin (tumour roundness score = 28.45). Surgery confirmed invasive ductal carcinoma with LN metastasis. Immunohistochemistry tests demonstrated PR positivity, HER2 negativity, and negative Ki-67 results.</p

The Role of High-Resolution Magic Angle Spinning 1H Nuclear Magnetic Resonance Spectroscopy for Predicting the Invasive Component in Patients with Ductal Carcinoma In Situ Diagnosed on Preoperative Biopsy

<div><p>The purpose of this study was to evaluate the role of high-resolution magic angle spinning (HR-MAS) 1H nuclear magnetic resonance (NMR) spectroscopy in patients with ductal carcinoma <i>in situ</i> (DCIS) diagnosed on preoperative biopsy. We investigated whether the metabolic profiling of tissue samples using HR-MAS 1H NMR spectroscopy could be used to distinguish between DCIS lesions with or without an invasive component. Our institutional review board approved this combined retrospective and prospective study. Tissue samples were collected from 30 patients with pure DCIS and from 30 with DCIS accompanying invasive carcinoma. All patients were diagnosed with DCIS by preoperative core-needle biopsy and underwent surgical resection. The metabolic profiling of tissue samples was performed by HR-MAS 1H NMR spectroscopy. All observable metabolite signals were identified and quantified in all tissue samples. Metabolite intensity normalized by total spectral intensities was compared according to the tumor type using the Mann-Whitney test. Multivariate analysis was performed with orthogonal projections to latent structure-discriminant analysis (OPLS-DA). By univariate analysis, the metabolite concentrations of choline-containing compounds obtained with HR-MAS 1H NMR spectroscopy did not differ significantly between the pure DCIS and DCIS accompanying invasive carcinoma groups. However, the GPC/PC ratio was higher in the pure DCIS group than in the DCIS accompanying invasive carcinoma group (p = 0.004, Bonferroni-corrected p = 0.064), as well as the concentration of myo-inositol and succinate. By multivariate analysis, the OPLS-DA models built with HR-MAS MR metabolic profiles could clearly discriminate between pure DCIS and DCIS accompanying invasive carcinoma. Our preliminary results suggest that HR-MAS MR metabolomics on breast tissue may be able to distinguish between DCIS lesions with or without an invasive component.</p></div

HR-MAS 1H NMR Spectroscopic Values for the Whole Cohort.

<p>HR-MAS 1H NMR Spectroscopic Values for the Whole Cohort.</p