Large-Core Needle Biopsy of Nonpalpable Breast Lesions

Meyer, Jack E.; Smith, Dietrich C.; Lester, Susan C.; Kaelin, Carolyn M.; DiPiro, Pamela J.; Denison, Christine M.; Christian, Roger L.; Harvey, Susan C.; Selland, Donna Lee G.; Durfee, Sara M.

doi:10.1001/jama.281.17.1638

Cited by 233 publications

(110 citation statements)

References 22 publications

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“…The specimen radiogram taken after the biopsy shows the area where the SVC was performed and verifies the correct positioning of the biopsy needle (microcalcification, asymmetrical density, etc.). The occurrence rate for microcalcifications observed in specimen radiograms following SVC biopsies has been reported as 95-100% (Meyer et al, 1999). In our study, specimen radiograms taken after SVC demonstrated that samples had been taken from the correct target points.…”

Section: Discussionsupporting

confidence: 53%

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

Agacayak¹,

Ozturk²,

Bozdogan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson's Chi-square, continuity correction, and Fisher's exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55).Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures.

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Section: Discussionsupporting

confidence: 53%

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

Agacayak¹,

Ozturk²,

Bozdogan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Similar to this last problem is the diagnosis of atypical duct hyperplasia in a core biopsy with subsequent upgrade to DCIS. 11,[27][28][29] These are all problematic because the differentiation is based on either the size or extensiveness of the lesion; and in a core biopsy, sampling error and size estimation is a built-in limitation. These are significant as the treatment methods differ between the different differentials.…”

Section: Discussionmentioning

confidence: 99%

Predictors of invasion in needle core biopsies of the breast with ductal carcinoma in situ

Chan

Vong

et al. 2010

Modern Pathology

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A significant proportion of ductal carcinomas in situ (DCISs) of the breast diagnosed on core biopsies had invasion upon excision. An assessment of various invasion predictors in the biopsies yielded conflicting results. A cohort of 157 cases with needle core biopsy diagnosed with DCISs (including 109 histologically proven DCISs, and 48 cases with invasion upon excision) were evaluated for the numbers of positive and total cores, the percentage of positivity, lobular cancerization, tumor nuclear grade, necrosis, calcification, predominate histological pattern, lymphocytic infiltrate and excisional tumor size. The mean positive core percentage and excisional tumor size were 76% and 2.8 cm for invasive and 66% and 1.9 cm for noninvasive groups. In the biopsy of the invasive group, cancerization of lobules was present in 52%, and nuclear grades 1, 2 and 3 were present in 31, 31 and 38%, respectively. Large comedo and small noncomedo necroses were present in 48 and 10%, whereas large and small calcifications were present in 16 and 21%. Solid, cribriform and papillary patterns were observed in 88, 38 and 21%, respectively. Moderate to marked lymphoid infiltrate was present in 31%. In the biopsy of the noninvasive group, cancerization of lobules was present in 69%, and the nuclear grades 1, 2 and 3 were present in 23, 48 and 29%, respectively. Large comedo and small noncomedo necroses were present in 35 and 11%, whereas large and small calcifications were present in 33 and 23%. Solid, cribriform and papillary patterns were observed in 85, 39 and 9%, respectively. Moderate to marked lymphoid infiltrate was present in 36%. Comparing these groups, a higher positive core percentage, papillary pattern and less cancerization of lobules in the cores and larger excisional tumor size were associated with a higher chance of invasion. Calcification, necrosis and nuclear grade were not significant invasion predictors.

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“…Technical advances in percutaneous core needle biopsy, such as increasing needle diameter from 14-gauge to 11-gauge and adding a vacuum device, have allowed larger samples of tissue to be obtained (5,6), substantially improving the accuracy of diagnosis. Despite these improvements, the rate of underestimation for ADH has been reported as 10% to 26% for 11-gauge vacuum-assisted biopsy (VAB) (2,14,(21)(22)(23)(24)(25)(26)(27)(28). In this study, 11-gauge SVAB was associated with a lower rate of underestimation for ADH (20.6%), compared to USguided 14-gauge automated biopsy (41.7%) (P = 0.007).…”

Section: Discussionmentioning

confidence: 86%

Factors that impact the upgrading of atypical ductal hyperplasia

Gümüş

Mills²,

Gümüş³

et al. 2012

Diagn Interv Radiol

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Large-Core Needle Biopsy of Nonpalpable Breast Lesions

Abstract: Image-guided LCNB is a reliable diagnostic alternative to surgical excision of suspicious nonpalpable breast abnormalities.

Cited by 233 publications

References 22 publications

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

Predictors of invasion in needle core biopsies of the breast with ductal carcinoma in situ

Factors that impact the upgrading of atypical ductal hyperplasia

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