Magnetic Resonance Imaging-Guided Core Needle Breast Biopsies Resulting in High-Risk Histopathologic Findings: Upstage Frequency and Lesion Characteristics

Weinfurtner, R. Jared; Patel, Bhavika; Laronga, Christine; Lee, Marie Catherine; Falcon, Shannon; Mooney, Blaise; Yue, Binglin; Drukteinis, Jennifer S.

doi:10.1016/j.clbc.2014.12.005

Cited by 21 publications

(16 citation statements)

References 20 publications

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“…There is a paucity of data, however, as to the rate of upgrade and need for excision of ADH and lobular neoplasia when the diagnosis is made following abnormal MRI. Studies have shown that high‐risk lesions detected via MRI, will be upgraded to malignancy upon excision, at a variable rate, ranging from 15%‐50% for ADH and 0%‐33% for lobular neoplasia (LN) …”

Section: Introductionsupporting

confidence: 85%

“…Review of the literature provides minimal consensus regarding the risk of upgrade for MRI‐detected atypical lesions, with estimates ranging from 15%‐50% for ADH and 0%‐33% for LN . The overall upgrade rate of 24.3%, observed in the present study, is consistent with cited literature for MRI‐detected lesions, as well as for mammographically identified atypical lesions.…”

Section: Discussionmentioning

confidence: 99%

“…The present study identified an upgrade rate of 29.2% for LN, with no distinction observed between LCIS and ALH. The reported upgrade rate of MRI‐identified LN varies, with rates ranging from 0% to 33% . Susnik et al aimed to identify the subset of cases of LN which conferred the greatest risk and found that upgrade was present in 3.5% (8/228) of classic LN, 26.7% (4/15) of LCIS variants, and 28.3% (15/53) of cases with coexistent ductal atypia.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that high-risk lesions detected via MRI, will be upgraded to malignancy upon excision, at a variable rate, ranging from 15%-50% for ADH 5,7-9 and 0%-33% for lobular neoplasia (LN). 5,7,[10][11][12] It is not known whether the upgrade rate of high-risk lesions varies among women with atypia found on screening MRI vs women with Abstract Adjunct magnetic resonance imaging (MRI) for both screening high-risk patients and staging for patients with newly diagnosed breast cancer leads to an increased number of biopsies and increased detection of atypical lesions. We assessed whether the malignancy upgrade frequency for high-risk atypia identified via MRI-guided biopsies varied based on indication: high-risk screening vs staging for malignancy.Among 399 MRI-guided biopsies, 46 (11.5%) high-risk lesions (ADH, ALH, and LCIS) were identified.…”

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confidence: 99%

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Screening vs staging magnetic resonance imaging‐guided core needle breast biopsies: Does MRI indication impact upgrade rate?

et al. 2019

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Adjunct magnetic resonance imaging (MRI) for both screening high‐risk patients and staging for patients with newly diagnosed breast cancer leads to an increased number of biopsies and increased detection of atypical lesions. We assessed whether the malignancy upgrade frequency for high‐risk atypia identified via MRI‐guided biopsies varied based on indication: high‐risk screening vs staging for malignancy. Among 399 MRI‐guided biopsies, 46 (11.5%) high‐risk lesions (ADH, ALH, and LCIS) were identified. Surgical excision was performed on 37% of 46%, and 24.3% were upgraded to invasive malignancy or DCIS. Of lesions identified by staging MRI, a slightly higher percentage, 28.5%, were upgraded (P = .36). Our data suggest that surgeons should carefully consider excisional biopsy for atypia identified on MRI regardless of indication.

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Section: Introductionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Screening vs staging magnetic resonance imaging‐guided core needle breast biopsies: Does MRI indication impact upgrade rate?

et al. 2019

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“…However, with the exception of atypical hyperplasia and very dense breasts, the risk associated with each of these factors is modest. Even the strongest risk factors of atypia (47, 48) and dense breasts (49) identify many women who will never develop breast cancer, leading to a search for molecular markers that would increase both the sensitivity and the specificity of present risk assessment methods.…”

Section: Discussionmentioning

confidence: 99%

Gene Methylation and Cytological Atypia in Random Fine-Needle Aspirates for Assessment of Breast Cancer Risk

Stearns

Fackler

Hafeez

et al. 2016

Cancer Prevention Research

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Methods to determine individualized breast cancer risk lack sufficient sensitivity to select women most likely to benefit from preventive strategies. Alterations in DNA methylation occur early in breast cancer. We hypothesized that cancer-specific methylation markers could enhance breast cancer risk assessment. We evaluated 380 women without a history of breast cancer. We determined their menopausal status or menstrual cycle phase, risk of developing breast cancer (Gail model), and breast density, and obtained random fine needle aspiration (rFNA) samples for assessment of cytopathology and cumulative methylation index (CMI). Eight methylated gene markers were identified through whole genome methylation analysis and included novel and previously established breast cancer detection genes. We performed correlative and multivariate linear regression analyses to evaluate DNA methylation of a gene panel as a function of clinical factors associated with breast cancer risk. CMI and individual gene methylation were independent of age, menopausal status or menstrual phase, lifetime Gail risk score, and breast density. CMI and individual gene methylation for the eight genes increased significantly (p<0.001) with increasing cytological atypia. The findings were verified with multivariate analyses correcting for age, log (Gail), log (percent density), rFNA cell number and BMI. Our results demonstrate a significant association between cytological atypia and high CMI, which does not vary with menstrual phase or menopause and is independent of Gail risk and mammographic density. Thus CMI is an excellent candidate breast cancer risk biomarker, warranting larger prospective studies to establish its utility for cancer risk assessment.

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New Thoughts on Atypias of the Breast: Flat Epithelial Atypia, Atypical Ductal Hyperplasia, and Lobular Neoplasia

Sullivan

2017

Changing Paradigms in the Management of Breast Cancer

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Magnetic Resonance Imaging-Guided Core Needle Breast Biopsies Resulting in High-Risk Histopathologic Findings: Upstage Frequency and Lesion Characteristics

Cited by 21 publications

References 20 publications

Screening vs staging magnetic resonance imaging‐guided core needle breast biopsies: Does MRI indication impact upgrade rate?

Screening vs staging magnetic resonance imaging‐guided core needle breast biopsies: Does MRI indication impact upgrade rate?

Gene Methylation and Cytological Atypia in Random Fine-Needle Aspirates for Assessment of Breast Cancer Risk

New Thoughts on Atypias of the Breast: Flat Epithelial Atypia, Atypical Ductal Hyperplasia, and Lobular Neoplasia

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