Radiography of microcalcifications in stereotaxic mammary core biopsy specimens.

Liberman, Laura; Evans, W. Phil; Dershaw, D. David; Hann, Lucy E.; Deutch, B M; Abramson, A F; Rosen, Peter

doi:10.1148/radiology.190.1.8259409

Cited by 148 publications

(62 citation statements)

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“…As the technology has evolved, many radiologists have increased both the needle bore size, to 11 G, and the number of cores that are retrieved during each needle core biopsy procedure (4,5,10). Finally, most centers now obtain routine radiographs of NCBB specimens, after retrieval and before histologic processing, which has been shown to optimize sensitivity by verifying the presence of microcalcifications within the cores and tissue sections (4,12).…”

Section: Discussionmentioning

confidence: 99%

Histopathologic Analysis of Atypical Lesions in Image-Guided Core Breast Biopsies

et al. 2003

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Stereotactic or ultrasound-guided needle core breast biopsies (NCBB) are now routinely performed to assess suspicious microcalcifications or non-palpable masses detected by screening mammography. This approach has been shown to have high sensitivity and specificity in establishing the diagnosis of fibrocystic lesions, ductal carcinoma in situ (DCIS), and invasive carcinoma (1). As more NCBB are being performed, pathologists are encountering lesions with features of atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH). There are two issues that impact the clinical evaluation of patients with atypical lesions in NCBB samples. First, malignant lesions are known to frequently coexist with ADH/ALH, either within the same segment of breast tissue or in different quadrants (the latter as a manifestation of so-called field effect alteration). Because of partial/limited sampling, it is thus theoretically possible that at least some patients with atypia on NCBB may harbor occult DCIS. This problem is highlighted by the consideration that histologic distinction between ADH and DCIS is partially quantitative in nature (2, 3). Second, microfocal lesions may be missed during the process of trimming the block (so-called sectioning artifact). This problem is exacerbated if cores are fragmented or associated with crushing,

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Section: Discussionmentioning

confidence: 99%

Histopathologic Analysis of Atypical Lesions in Image-Guided Core Breast Biopsies

et al. 2003

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“…9 If stereotactic large-core needle biopsy was performed to assess the nature of mammographic microcalcifications, specimen mammography was carried out. 10 Before performing stereotactic large-core needle biopsy procedures, radiologists underwent special training: first they attended 10 biopsy procedures and subsequently they performed another 10 biopsy procedures under the supervision of a radiologist with considerable experience in stereotactic large-core needle biopsy.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic accuracy of stereotactic large‐core needle biopsy for nonpalpable breast disease: Results of a multicenter prospective study with 95% surgical confirmation

Verkooijen

2002

Intl Journal of Cancer

139

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Stereotactic large-core needle biopsy is increasingly applied for the diagnosis of nonpalpable breast disease. Our study examines whether this minimally invasive technique is sufficiently accurate to replace surgical breast biopsy. In a prospective multicenter study, 973 consecutive women with 1,029 nonpalpable breast lesions were offered stereotactic 14-gauge needle biopsy. If the needle biopsy yielded breast cancer, the patient was offered therapeutic surgery. Surgical biopsy was proposed in cases of needle biopsies without malignancy. An expert panel reviewed all discrepancies in histologic diagnosis between the needle biopsy and open biopsy. Forty-five patients withdrew from participation and 113 (11%) planned needle biopsy procedures were cancelled. Of the 871 successful biopsy procedures, 95% were confirmed surgically. In 13 cases (1.5%), insufficient material was obtained for histologic assessment. Fifty-five percent of the needle biopsies were diagnosed as malignant (290 invasive cancers, 190 ductal carcinoma in situ). Thirteen of the 322 lesions (4%, 95% CI 2-7%) with a benign needle biopsy diagnosis contained malignancy after surgery. Six of the 26 (23%, 95% CI 9 -44%) lesions with a high-risk diagnosis (atypical ductal or lobular hyperplasia or lobular carcinoma in situ) were diagnosed as malignant after surgery. Five of the 30 lesions containing normal breast tissue held malignancy (17%, 95% CI 6 -35%). Guidelines for the management of different categories of needle biopsy diagnoses were made. Application of these guidelines to the present findings resulted in sensitivity and specificity rates of 97% (95% CI 95-98%) and 99% (95% CI 97-100%), respectively. Stereotactic large-core needle biopsy is an accurate diagnostic instrument for nonpalpable breast disease. It may safely replace needle localised open-breast biopsy provided that high-risk and normal breast tissue diagnoses are followed by needle or openbreast biopsy.

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“…The failure rate was significantly lower by 14-gaugebiopsy with the vacuum-assisted device than with the large-coredevice [12â€ "14]. Histologic accuracy is significantly higher in specimensthatcontaincalcifications [26,27].…”

Section: Biopsytechniques For Removal Of Benignbreastlesionsmentioning

confidence: 99%

Percutaneous removal of benign mammographic lesions: comparison of automated large-core and directional vacuum-assisted stereotactic biopsy techniques.

Jackman¹,

Marzoni²,

Nowels³

1998

American Journal of Roentgenology

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RogerJ.FrancisA. Marzoni,Jr.2 KentW. Nowels3OBJECTIVE. The purposeof our studywas to evaluatehow often histologicallybenign lesions were completely removed as shown by the initial mammogram after biopsy. We corn pared three percutaneousbiopsy techniques.MATERIALS AND METHODS. Retrospective review wasperformedon 1206 consec utive impalpable breast lesions having percutaneous stereotactic biopsies done on a prone bi opsy table using 14-gauge automated large-core needles (n = 721); 14-gauge directional vacuum-assisted probes (n = 192); and 1I-gauge directional vacuum-assisted probes (n = 293). Lesions that were histologically benign and that did not have subsequent surgical cxci sion had mammographic follow-up. The 667 initial mammograms after biopsy (advised to be doneat 6 or 12 monthsand accomplishedat 1â€"53 months[median,7 months]after biopsy) were reviewed to see if the lesions were no longer apparent.RESULTS. The lesion was absentin 9% (40/422) of lesionsfor which 14-gaugelarge core biopsy was used, 22% (21/95) of lesions for which 14-gauge vacuum-assistedbiopsy was used, and 64% (96/150) of lesions for which I I-gauge vacuum-assisted biopsy was used

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Radiography of microcalcifications in stereotaxic mammary core biopsy specimens.

Abstract: Specimen radiography should be routinely performed in stereotaxic core biopsies of breast microcalcifications to ensure appropriate tissue has been obtained and to direct pathologic diagnosis of the tissue specimens.

Cited by 148 publications

References 0 publications

Histopathologic Analysis of Atypical Lesions in Image-Guided Core Breast Biopsies

Histopathologic Analysis of Atypical Lesions in Image-Guided Core Breast Biopsies

Diagnostic accuracy of stereotactic large‐core needle biopsy for nonpalpable breast disease: Results of a multicenter prospective study with 95% surgical confirmation

Percutaneous removal of benign mammographic lesions: comparison of automated large-core and directional vacuum-assisted stereotactic biopsy techniques.

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