Accuracy and Upgrade Rates of Percutaneous Breast Biopsy: The Surgeon's Role

2010 ◽  
Vol 76 (10) ◽  
pp. 1084-1087 ◽  
Author(s):  
Windy Olaya ◽  
Won Bae ◽  
Jan Wong ◽  
Jasmine Wong ◽  
Sharmila Roy-Chowdhury ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Breast Imaging ◽  
Breast Biopsy ◽  
Imaging Study ◽  
Surgical Excision ◽  
Core Size ◽  
Image Guided ◽  
Core Samples ◽  
Limited Sampling ◽  
The Impact

We sought to evaluate the impact of needle core size and number of core samples on diagnostic accuracy and upgrade rates for image-guided core needle biopsies of the breast. A total of 234 patients underwent image-guided percutaneous needle biopsies and subsequent surgical excision. Large-core needles (9 gauge or less) were used in 14.5 per cent of cases and the remainder were performed with smaller core needles. More than four core samples were taken in 78.9 per cent of patients. In 71.8 per cent of cases, needle biopsy pathology matched surgical excision pathology. After surgical excision, upgraded pathology was revealed in 10.7 per cent of cases. Of 11 patients (52.4%) with benign needle core pathology who had upgraded final pathology on surgical excision, 10 had a Breast Imaging Recording and Data System score 4 or 5 imaging study. Lesions smaller than 10 mm were more likely to be misdiagnosed ( P = 0.01) or have upgraded pathology ( P = 0.009). Other predictors of upgraded pathology were patient age 50 years or older ( P = 0.03) and taking four or fewer core samples ( P = 0.003). Needle core size did not impact accuracy or upgrade rates. Surgeons should exercise caution when interpreting needle biopsy results with older patients, smaller lesions, and limited sampling. Discordant pathology and imaging still mandate surgical confirmation.

scholarly journals Intraductal Papilloma Without Atypia on Image- Guided Breast Biopsy: Upgrade Rates to Carcinoma at Surgical Excision

Breast Care ◽  
2018 ◽  
Vol 13 (5) ◽  
pp. 364-368 ◽  
Author(s):  
Doris Leithner ◽  
Benjamin Kaltenbach ◽  
Petra Hödl ◽  
Volker Möbus ◽  
Volker Brandenbusch ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Breast Biopsy ◽  
Ductal Carcinoma ◽  
Statistical Tests ◽  
Menopausal Status ◽  
Surgical Excision ◽  
Lesion Size ◽  
Intraductal Papilloma ◽  
Image Guided ◽  
Institutional Review

Background: The management of intraductal papilloma without atypia (IDP) in breast needle biopsy remains controversial. This study investigates the upgrade rate of IDP to carcinoma and clinical and radiologic features predictive of an upgrade. Methods: Patients with a diagnosis of IDP on image-guided (mammography, ultrasound, magnetic resonance imaging) core needle or vacuum-assisted biopsy and surgical excision of this lesion at a certified breast center between 2007 and 2017 were included in this institutional review board-approved retrospective study. Appropriate statistical tests were performed to assess clinical and radiologic characteristics associated with an upgrade to malignancy at excision. Results: For 60 women with 62 surgically removed IDPs, the upgrade rate to malignancy was 16.1% (10 upgrades, 4 invasive ductal carcinoma, 6 ductal carcinoma in situ). IDPs with upgrade to carcinoma showed a significantly greater distance to the nipple (63.5 vs. 36.8 mm; p = 0.012). No significant associations were found between upgrade to carcinoma and age, menopausal status, lesion size, microcalcifications, BI-RADS descriptors, initial BI-RADS category, and biopsy modality. Conclusion: The upgrade rate at excision for IDPs diagnosed with needle biopsy was higher than expected according to some guideline recommendations. Observation only might not be appropriate for all patients with IDP, particularly for those with peripheral IDP.

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.

Accuracy and upgrade rates of stereotactic vacuum-assisted breast biopsy: Impact of number of core samples taken on malignancy underestimation rates.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 20-20
Author(s):  
J. A. Vossen ◽  
S. D. Edwards ◽  
M. Pronovost ◽  
P. Reeser
Keyword(s):  
Breast Biopsy ◽  
Ductal Carcinoma ◽  
Surgical Excision ◽  
Accurate Information ◽  
Breast Lesions ◽  
Core Samples ◽  
Significant Difference ◽  
Stereotactic Vacuum Assisted Biopsy ◽  
Underestimation Rate ◽  
The Impact

20 Background: There are multiple options for the diagnostic evaluation of mammographic suspicious breast abnormalities. The therapeutic strategy is often based on lesion histopathological information obtained from stereotactic vacuum-assisted biopsy (VAB). Therefore, accurate information obtained by VAB is very important. This study was performed to evaluate the impact of the number of core samples obtain during VAB on malignancy underestimation rates for mammographically detected breast lesions. Methods: The pathologic results of 128 consecutive stereotactic biopsies (January 2010-December 2010) were retrospectively reviewed. All biopsies were performed using a 9-gauge needle. Pathologic results of core biopsies and surgical excision were compared. Underestimation rates of malignancy were calculated and correlation was made with the number of core samples obtained. Results: Surgical excision was performed on 41% (52/128) lesions; 4 benign, 19 indeterminate and 29 malignant. Overall malignancy underestimation rate was 19%. There were 8 cases of ductal carcinoma in situ (DCIS) on core biopsy that were proven to be invasive ductal carcinoma (IDC) on surgical excision. There was one case of benign microcalcifications that was proven to be lobular neoplasia (LN). There was one case of an atypical papillary lesion that was proven to be DCIS. There was a significant difference (p=0.02) between the mean number of core samples taken in the underdiagnosed lesions (8, range 6-12) and the concordant lesions (10, range 6-20). Conclusions: In the case of stereotactic VAB diagnosis of breast lesions, the underestimation rate of malignancy is more likely with a lower number of core samples obtained.

scholarly journals Radial scar on image-guided breast biopsy: is surgical excision necessary?

2018 ◽  
Vol 170 (2) ◽  
pp. 313-320 ◽  
Author(s):  
Wendy Yen Yun Chou ◽  
Deborah J. Veis ◽  
Rebecca Aft
Keyword(s):  
Breast Biopsy ◽  
Surgical Excision ◽  
Radial Scar ◽  
Image Guided

Image-guided core needle biopsy in the diagnosis of malignant lymphoma: comparison with surgical excision biopsy

2020 ◽  
Vol 127 ◽  
pp. 108990
Author(s):  
Shohei Chatani ◽  
Takaaki Hasegawa ◽  
Seiichi Kato ◽  
Shinichi Murata ◽  
Yozo Sato ◽  
...  
Keyword(s):  
Malignant Lymphoma ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Surgical Excision ◽  
Excision Biopsy ◽  
Core Needle ◽  
Image Guided

The impact of image guided needle biopsy on the outcome of mammographically detected indeterminate microcalcification

The Breast ◽  
2006 ◽  
Vol 15 (5) ◽  
pp. 635-639 ◽  
Author(s):  
M.A. Al-Attar ◽  
M.J. Michell ◽  
G. Ralleigh ◽  
D. Evans ◽  
R. Wasan ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Image Guided ◽  
The Impact

scholarly journals Ultrasound-guided vacuum-assisted breast biopsy with a small-caliber device: A multicenter consecutive study of 162 biopsied lesions

2018 ◽  
Vol 105 (4) ◽  
pp. 312-318
Author(s):  
Christophe Tourasse ◽  
Elina Khasanova ◽  
Philippe Sebag ◽  
Jean Paul Beregi
Keyword(s):  
Needle Biopsy ◽  
Breast Imaging ◽  
Breast Lesion ◽  
Breast Biopsy ◽  
Ultrasound Guided ◽  
Diagnostic Potential ◽  
Vacuum Biopsy ◽  
Representative Samples ◽  
Complex Lesions ◽  
Biopsy Method

Objective: In this study, we aimed to analyze technical and diagnostic potential, and safety of the small-caliber vacuum-assisted biopsy (SCVAB) device in a multicenter consecutive study taking into consideration the type and location of breast lesion. Methods: We collected data from 5 breast imaging centers where radiologists used the SCVAB device for biopsies in 162 patients. We analyzed the conditions for using the SCVAB device according to the characteristics of the lesions, the volume of excision, and the analyzability obtained by biopsy samples. Results: The biopsies of 80 circumscribed masses, 61 complex lesions, and 24 microcalcification foci were included in the study. The reasons for choosing SCVAB as an initial technique were identified. A total of 47 lesions were removed with SCVAB; among them, 24 lesions were initially chosen for total excision. SCVAB was used as a second-choice biopsy method after core-needle biopsy failure in 20 cases. If SCVAB had not been available, vacuum-assisted biopsy would have been the most frequently used technique (106 under ultrasound, and 18 under stereotactical guidance). Conclusions: The SCVAB system is an alternative to classical vacuum biopsy, enabling representative samples to be obtained from lesions that are difficult to access, complex, small, or in cases of unsuccessful previous biopsy. The SCVAB system was determined as the chosen technique by the radiologists in this study due to feasibility, ergonomics and absence of side effects detected in this study.

scholarly journals The Impact of Breast Density Notification Laws on Supplemental Breast Imaging and Breast Biopsy

2019 ◽  
Vol 34 (8) ◽  
pp. 1441-1451 ◽  
Author(s):  
Loren Saulsberry ◽  
Lydia E. Pace ◽  
Nancy L. Keating
Keyword(s):  
Breast Density ◽  
Breast Imaging ◽  
Breast Biopsy ◽  
The Impact

Optimizing the Patient Experience during Breast Biopsy

2019 ◽  
Vol 1 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Mary Scott Soo ◽  
Rebecca A Shelby ◽  
Karen S Johnson
Keyword(s):  
Patient Satisfaction ◽  
Patient Experience ◽  
Breast Imaging ◽  
Breast Biopsy ◽  
Patient Communication ◽  
Patient Perspectives ◽  
Core Needle ◽  
Image Guided ◽  
Family Centered ◽  
Patient Concerns

Abstract For years, breast imaging has been the model in radiology for patient communication, and more recently, it has been a leader in the growing patient- and family-centered approach to care. To maintain high levels of patient satisfaction during image-guided core-needle breast biopsies, the radiologist should understand patient perspectives so that interventions can be developed to manage patient concerns. This article reviews patient perspectives before, during, and after imaging-guided breast biopsies, and it describes strategies to help optimize the experiences of patients as they navigate the process.

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