scholarly journals Results of Short-Term Follow-Up in BI-RADS 3 and 4a Breast Lesions with a Histological Diagnosis of Fibroadenoma at Percutaneous Needle Biopsy

Breast Care ◽  
2017 ◽  
Vol 12 (4) ◽  
pp. 238-242
Author(s):  
Paola Clauser ◽  
Massimo Bazzocchi ◽  
Magda Marcon ◽  
Viviana Londero ◽  
Chiara Zuiani
Keyword(s):  
Needle Biopsy ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
False Negative ◽  
Phyllodes Tumor ◽  
Clinical History ◽  
Histological Diagnosis ◽  
Short Term ◽  
Invasive Lobular Cancer

Objective: To evaluate the usefulness of short-term (6 months) follow-up in patients with Breast Imaging Report and Data System (BI-RADS) 3 and 4a lesions, after a diagnosis of fibroadenoma at an image-guided biopsy. Patients and Methods: The data of 318 women with 349 biopsy-proven fibroadenomas, a 6-month follow-up, and a follow-up of ≥ 24 months were retrospectively reviewed. Information on clinical history, lesion characteristics on ultrasound (US), mammography, and magnetic resonance imaging (MRI), BI-RADS classification, and follow-up was collected. The false-negative (FN) rate and the negative predictive value (NPV) for the biopsy were calculated. Results: 43 patients (13.5%) presented with a palpable nodule; 18 (5.7%) had a history of breast cancer. There were 334 lesions visible on US (95.7%), 57 on US and mammography (16.3%), and 15 on mammography only (4.3%); 37 lesions were first detected on MRI. All lesions were stable at 6 months. After an at least 1-year follow-up, 4 lesions changed their features and were excised. Histology showed 1 invasive lobular cancer, 1 ductal carcinoma in situ, 1 phyllodes tumor, and 1 papilloma. The FN rate of the needle biopsy was 1.1% and the NPV was 98.9%. Conclusion: For lesions initially described as BI-RADS 3 and 4a with a histological diagnosis of fibroadenoma after biopsy, short-term follow-up can be avoided.

scholarly journals Encapsulated Papillary Carcinoma of the Breast: Imaging Features with Histopathologic Correlation

2020 ◽  
Vol 2 (6) ◽  
pp. 590-597
Author(s):  
Sarah E Bonnet ◽  
Gloria J Carter ◽  
Wendie A Berg
Keyword(s):  
Papillary Carcinoma ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Imaging Features ◽  
Term Survival ◽  
Core Needle ◽  
Cystic Component

Abstract Encapsulated papillary carcinoma (EPC) is a rare, clinically indolent breast malignancy most common in postmenopausal women. Absence of myoepithelial cells at the periphery is a characteristic feature. Mammographically, EPC typically presents as a mostly circumscribed, noncalcified, dense mass that can have focally indistinct margins when there is associated frank invasive carcinoma. Ultrasound shows a circumscribed solid or complex cystic and solid mass, and occasional hemorrhage in the cystic component may produce a fluid-debris level; the solid components typically show intense washout enhancement on MRI. Color Doppler may demonstrate a prominent vascular pedicle and blood flow within solid papillary fronds. Encapsulated papillary carcinoma can exist in pure form; however, EPC is often associated with conventional ductal carcinoma in-situ and/or invasive ductal carcinoma, no special type. Adjacent in-situ and invasive disease may be only focally present at the periphery of EPC and potentially unsampled at core-needle biopsy. In order to facilitate diagnosis, the mass wall should be included on core-needle biopsy, which will show absence of myoepithelial markers. Staging and prognosis are determined by any associated frankly invasive component, with usually excellent long-term survival and rare distant metastases.

Stereotactic, Automated, Large-Core Needle Biopsy of Nonpalpable Breast Lesions: False-Negative and Histologic Underestimation Rates after Long-term Follow-up

Radiology ◽  
1999 ◽  
Vol 210 (3) ◽  
pp. 799-805 ◽  
Author(s):  
Roger J. Jackman ◽  
Kent W. Nowels ◽  
Jorge Rodriguez-Soto ◽  
Francis A. Marzoni ◽  
Solon I. Finkelstein ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
False Negative ◽  
Breast Lesions ◽  
Large Core ◽  
Core Needle ◽  
Long Term Follow Up ◽  
Nonpalpable Breast Lesions

scholarly journals Ultrasound-Guided Core-Needle Biopsy of Suspicious Breast Lesions

2020 ◽  
Vol 5 (2) ◽  
pp. 48-55
Author(s):  
Kincső-Zsófia Lőrincz ◽  
Zsuzsánna Pap ◽  
Simona Lileana Mocan ◽  
Csanád-Endre Lőrincz ◽  
Beáta-Ágota Baróti
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Screening Program ◽  
Core Needle ◽  
Luminal B ◽  
Triple Assessment ◽  
Mean Size ◽  
The Mean

AbstractBackground: Breast cancer is the female cancer with the highest mortality. While early detection is a public health priority in Western European countries, a screening program in our country has yet to be implemented. The best diagnostic accuracy is achieved through the use of triple assessment: clinical examination, imaging, and core-needle biopsy where indicated. Prognosis is influenced by clinical, histological, and biological factors, and therapy is most effective when individually tailored.Aim of the study: To analyze the clinical, histological, and immunohistochemical characteristics of the biopsied nodules and summarize our experience from the last three years.Material and Methods: We retrospectively analyzed data from 137 patients who underwent core-needle biopsy between 2017 and 2019. Imaging score was assigned based on ultrasound examination or mammography. Clinical and pathological parameters were recorded, followed by statistical processing of the data.Results: The mean age of the patients was 58 ± 14 years, lesions had a mean size of 22.83 ± 14.10 mm. Most nodules (n = 63, 47.01%) were located in the upper-outer quadrant, and bilateral presence was found in 4 (3.08%) cases. We found a significant positive correlation between lesion size and the patients’ age (Spearman r = 0.356; 95% CI 0.186, 0.506; p = 0.000). The malignancy rates within the Breast Imaging Reporting and Data System (BI-RADS) categories were as follows: 0% for „4a”, 31.58% for „4b”, 71.42% for „4c”, and 97.72% for „5”. Most malignancies (n = 73, 78.35%) were represented by invasive ductal carcinoma of no special type, 58.43% (n = 52) were grade 2, 89.13% (n = 82) were estrogen receptor positive, and Luminal B-like type was the most common (n = 63, 78.75%).Conclusions: The mean size of tumors was larger than the average size at discovery described in the literature. In our region, age and tumor size are positively correlated. Preoperative histological results may indicate the reliability of the imaging risk stratification system. Most cases can benefit from adjuvant endocrine therapy.

scholarly journals Pure Radial Scars Do Not Require Surgical Excision When Concordant and Benign at Image-guided Breast Biopsy

2021 ◽  
Author(s):  
Maria Piraner ◽  
Kelly D’Amico ◽  
Lawrence L Gilliland ◽  
Mary S Newell ◽  
Michael A Cohen
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Breast Imaging ◽  
Breast Biopsy ◽  
Surgical Excision ◽  
Study Cohort ◽  
Core Needle ◽  
Imaging Characteristics

Abstract Objective To determine the best management option (surgical excision versus imaging surveillance) following the diagnosis of pure radial scars (RSs) and RSs with associated additional high-risk lesions (HRLs) encountered on percutaneous core-needle breast biopsy. Methods An IRB–approved retrospective review of the breast imaging reporting system database was performed to identify all cases of pure RS alone or RS plus an additional HRL (papilloma, atypia, lobular neoplasia) diagnosed on core-needle biopsy, from 2007 to 2016, at four breast centers in our institution. Cases with associated malignancy, discordant radiologic-pathologic results, or those lost to follow-up were excluded. The remaining cases were evaluated to determine results of either subsequent surgical excision or long-term follow-up imaging (minimum of two years). Additional data recorded included clinical presentation, breast density, personal and family history of breast cancer, lesion imaging characteristics, and biopsy method. Results The study cohort included 111 patients with 111 lesions: 56.8% (63/111) with RS alone (pure) and 43.2% (48/111) with RS plus additional HRL(s). Out of the 63 radiologic-pathologic concordant pure RSs, there were no upgrades to malignancy in 51 subsequent surgical excisions or 12 long-term surveillance cases (0/63, 0%). Out of the 48 RSs plus additional HRL(s), there were 2 upgrades to malignancy (2/48, 4.2%). Conclusion Cases of radiologic-pathologic concordant pure RS diagnosed at core-needle biopsy do not require surgical excision. On the other hand, surgical excision should be considered for RS plus additional HRLs diagnosed at core-needle biopsy.

Rare pulmonary tumors and carcinoma mimickers; experience from an interventional radiology unit with radiologic-pathologic correlation-A pictoral essay

2021 ◽  
Vol 17 ◽  
Author(s):  
Emre Ünal ◽  
Sevtap Arslan ◽  
Gulnar Aghayeva ◽  
Yasin Sarıkaya ◽  
Türkmen Çiftçi ◽  
...  
Keyword(s):  
False Negative ◽  
Clinical History ◽  
Ct Scans ◽  
Pulmonary Lesions ◽  
Pathologic Correlation ◽  
Pet Ct ◽  
Malignant Lesions ◽  
Slow Growing ◽  
Pulmonary Tumors

Background: Although imaging findings along with patients’ clinical history may give clue for the etiology of a pulmonary lesion, the differentiation of benign pulmonary lesions from lung cancer could be challenging. Objective: The aim of this review article was to increase the awareness of the carcinoma mimicking lung lesions. Methods: This paper was designed to illustrate rare pulmonary tumors and carcinoma mimickers with emphasis on radiologic-pathologic correlation. Pitfalls encountered on CT images and also false positivity of PET-CT scans were also presented. Conclusion: Several benign pulmonary lesions may grow in size on follow-up and some may show pathologic FDG (18F-fluorodeoxyglucose) uptake, which makes them indistinguishable from lung carcinoma by imaging. In addition, some slow-growing malignant lesions, such as carcinoid, may be false-negative on PET/CT scans.

Short-term follow-up in 6 months is unnecessary for asymptomatic breast lesions with benign concordant results obtained at ultrasonography-guided 14-gauge core needle biopsy

2016 ◽  
Vol 211 (1) ◽  
pp. 152-158 ◽  
Author(s):  
Hee Jung Moon ◽  
Inkyung Jung ◽  
Ji Hyun Youk ◽  
Min Jung Kim ◽  
Eun-Kyung Kim
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Breast Lesions ◽  
Short Term ◽  
Core Needle

scholarly journals The lobular neoplasia enigma: management and prognosis in a long follow-up case series

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jasna Metovic ◽  
Simona Osella Abate ◽  
Fulvio Borella ◽  
Elena Vissio ◽  
Luca Bertero ◽  
...  
Keyword(s):  
Carcinoma In Situ ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Malignant Lesion ◽  
Case Series ◽  
Lobular Neoplasia ◽  
Aggressive Disease

Abstract Background Many oncologists debate if lobular neoplasia (LN) is a risk factor or an obligatory precursor of more aggressive disease. This study has three aims: (i) describe the different treatment options (surgical resection vs observation), (ii) investigate the upgrade rate in surgically treated patients, and (iii) evaluate the long-term occurrences of aggressive disease in both operated and unoperated patients. Methods A series of 122 patients with LN bioptic diagnosis and follow-up information were selected. Clinical, radiological, and pathological data were collected from medical charts. At definitive histology, either invasive or ductal carcinoma in situ was considered upgraded lesions. Results Atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS), and high-grade LN (HG-LN) were diagnosed in 44, 63, and 15 patients, respectively. The median follow-up was 9.5 years. Ninety-nine patients were surgically treated, while 23 underwent clinical-radiological follow-up. An upgrade was observed in 28/99 (28.3%). Age ≥ 54 years (OR 4.01, CI 1.42–11.29, p = 0.009), Breast Imaging-Reporting and Data System (BI-RADS) categories 4–5 (OR 3.76, CI 1.37–10.1, p = 0.010), and preoperatory HG-LN diagnosis (OR 8.76, 1.82–42.27, p = 0.007) were related to upgraded/aggressive disease. During follow-up, 8 patients developed an ipsilateral malignant lesion, four of whom were not initially operated (4/23, 17%). Conclusions BI-RADS categories 4–5, HG-LN diagnosis, and age ≥ 54 years were features associated with an upgrade at definitive surgery. Moreover, 17% of unoperated cases developed an aggressive disease, emphasizing that LN patients need close surveillance due to the long-term risk of breast cancer.

scholarly journals Once in a Blue Moon … Rare Adnexal Tumor: From the Clinical and Videodermoscopical Aspects to the Mohs Surgery and the Histological Diagnosis

2018 ◽  
Vol 6 (1) ◽  
pp. 146-148
Author(s):  
Miriam Rovesti ◽  
Francesca Satolli ◽  
Roberto Ricci ◽  
Roberta Manuguerra ◽  
Alfredo Zucchi ◽  
...  
Keyword(s):  
Ductal Carcinoma ◽  
Heterogeneous Group ◽  
Histological Diagnosis ◽  
Mohs Surgery ◽  
Adnexal Tumor

The adnexal tumours are a very heterogeneous group of lesions, more and more studied in the literature. The squamoid eccrine ductal carcinoma (SEDC) is a rare malignant variant that combines ductal structures with squamous differentiation.We report a case of dermoscopic and histological diagnosis of SEDC, treated with Mohs Surgery and with no recurrence of a tumour after 12 months of follow up.

scholarly journals Feasibility of the Less Is More Approach in Treating Low-Risk Ductal Carcinoma In Situ Diagnosed on Core Needle Biopsy: Ten-Year Review of Ductal Carcinoma In Situ Upgraded to Invasion at Surgery

2018 ◽  
Vol 142 (9) ◽  
pp. 1120-1126 ◽  
Author(s):  
Mirna B. Podoll ◽  
Emily S. Reisenbichler ◽  
Lania Roland ◽  
Andrew Bruner ◽  
Sarah Mizuguchi ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Low Risk ◽  
Low Grade ◽  
Core Needle

Context.— Ductal carcinoma in situ (DCIS) represents 20% of screen-detected breast cancers. The likelihood that certain types of DCIS are slow growing and may never progress to invasion suggests that our current standards of treating DCIS could result in overtreatment. The LORIS (LOw RISk DCIS) and LORD (LOw Risk DCIS) trials address these concerns by randomizing patients with low-risk DCIS to either active surveillance or conventional treatment. Objective.— To determine the upgrade rate of DCIS diagnosed on core needle biopsy to invasive carcinoma at surgery and to evaluate the safety of managing low-risk DCIS with surveillance alone, by characterizing the pathologic and clinical features of upgraded cases and applying criteria of the LORD and LORIS trials to these cases. Design.— A 10-year retrospective analysis of DCIS on core needle biopsy with subsequent surgery. Results.— We identified 1271 cases of DCIS on core needle biopsy: 200 (16%) low grade, 649 (51%) intermediate grade, and 422 (33%) high grade. Of the 1271 cases, we found an 8% upgrade rate to invasive carcinoma (n = 105). Nineteen of the 105 upgraded cases (18%) had positive lymph nodes. Low-grade DCIS was least likely to upgrade to invasion, comprising 10% (10 of 105) of upgraded cases. Three of the 105 upgraded cases (3%) met criteria for the LORD trial, and all were low-grade DCIS on core needle biopsy with favorable biology on follow-up. Conclusions.— There is a clear risk of upgrade to invasion on follow-up excision; however, applying strict criteria of the LORD trial effectively decreases the likelihood of a missed invasive component or missed aggressive pathologic features.

scholarly journals EVALUATION OF DIAGNOSTIC ACCURACY OF ULTRASOUND-GUIDED SEMI-AUTOMATED CORE NEEDLE BIOPSY OF BREAST SUSPICIOUS MICROCALCIFICATIONS

2020 ◽  
Vol 8 (10) ◽  
pp. 1039-1054
Author(s):  
Alyaa Saad Bunyan ◽  
◽  
Sarah Saad Bonyan ◽  
Akeel Saad Bonyan ◽  
◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Core Biopsy ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Benign Lesions ◽  
Ultrasound Guided ◽  
Core Needle ◽  
Final Pathology ◽  
Specimen Radiography

Back ground: Breast microcalcifications are considered an early mammographic sign of breast cancer which are present with tiny bright spots of different morphology. In an ultrasound (US) image, the presence of microcalcifications within breast is an important indicator of malignancy.With an improved sonographic detection of microcalcification, ultrasound could be used for biopsy guidance for target sampling of tissue containing suspicious microcalcifications. If the biopsied lesions had a suspicious microcalcifications, specimen radiograph is mandatory to confirm the presence of microcalcifications in which a core containing any calcification on specimen radiography was defined as asuccessfully retrieved core. 14-G(Gauge) semi-automated core needle biopsy(CNB) device is less costly than other biopsy device. Methods:A prospective study was conducted on thirty female patients with thirty- two lesions their mean age was 48.53 years (age range, 21-75 years) radiologically classified as BIRADS (Breast Imaging Reporting and Data system) 4 (b, c) and5 from those referred to women imaging health unit in Radiology department for Sono- Mammography and those patients were referred from the inpatient wards and outpatient clinics of the surgery departments during the period from September 2018 till May 2019.All patients underwent conventional digital mammography and B-mode ultrasound examination and Ultrasound guided biopsy, specimen radiography then tissue samples were sent to histopathology department in which slide picture was done.Then (28) females done surgery and (2) patient still for follow up. Results: Radiological diagnosis of our lesions using BIRADS(Breast Imaging Reporting and Data system) categorical method were identified as two intermediate suspicious lesions (BIRADS 4B 6.3 %), twelve moderate suspicious lesions (BIRADS 4C 34.4 %), and 19 highly suggestive of malignancy lesions (BIRADS 5 59.4 %). Retrieval rate of calcifications according to specimen radiography were successfully retrieved in 30/32 lesions (93.8 %) and confirmed on specimen radiography .CNB( core needle biopsy) identified 28 lesions (87.5 %) malignant and four (12.5 %) benign lesions. Distribution of lesions according to pathological diagnosis in successful and fail retrieval group, the successful retrieval group comprised 26 malignant (22 IDC(Invasive ductal carcinoma), 2 DCIS(Ductal carcinoma Insitu), 2 ILC(Invasive Lobuler carcinoma) ) and four benign lesions.After CNB( core needle biopsy), 30 lesions underwent surgical excision and final pathology results were provided. All 24 IDC on 14-G semi-automated CNB (core needle biopsy) were confirmed to be IDC(Invasive ductal carcinoma) on final pathology. Of the two DCIS(Ductal carcinoma Insitu) on US(Ultrasound) guided CNB( core needle biopsy), one DCIS, were upgraded to IDC, the other one confirmed to be DCIS on final pathology,the two ILC were confirmed to be ILC on final pathology.Of the four benign lesions, the two ADH(Atypical Ductal hyperplasia) underwent surgical excision, finally diagnosed as DCIS,the other two benign lesions (fibroadenoma and fibroadenosis) their BIRADS assessments were category 4C and were recommended for follow-up.The overall accuracy of US-guided 14-G(Gauge) semi-automated CNB( core needle biopsy) was 90.0 % (27/32). Conclusion: The present study confirms the good retrieval rate (93.8%) of US-guided 14-G semi-automated CNB and diagnostic accuracy of (90.0%). Thus, this could be useful procedure for suspicious microcalcifications apparent on sonography.Specimen radiography proved to be a great help in deciding the accurate retrieval of microclcifications by core biopsy. It should be done in all cases of core biopsy for calcifications with marking of the core containing calcifications to be specially assessed by histopathology. We should try to do core biopsy before using VAB (Vaccum-Assisted Biobsy)for calcifications if well seen by ultrasound.

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