Stereotactic Breast Biopsy of Nonpalpable Lesions: Determinants of Ductal Carcinoma in Situ Underestimation Rates

Abstract

DCIS underestimations were 1.9 times more frequent with masses than with calcifications, 1.8 times more frequent with large-core biopsy than with vacuum-assisted biopsy, and 1.5 times more frequent with 10 or fewer specimens per lesion than with more than 10 specimens per lesion.

Predictive factors for invasive cancer in surgical specimens following an initial diagnosis of ductal carcinoma in situ after stereotactic vacuum-assisted breast biopsy in microcalcification-only lesions

“…Although SVAB allows more accurate histopathologic results, underestimation still occurs (7,10,18). Some investigators have found rates of underestimation ranging from 5% to 29% for DCIS at SVAB (6,9,(11)(12)(13). In this study, the underestimation rate of DCIS was 18%.…”

“…Underestimation of DCIS lesions occurs when an invasive component is found after surgery, which had been missed at the initial preoperative sampling. The underestimation rate of stereotactic 14-gauge automated core biopsy in DCIS was reported as 16%-35% (9-11), while that of SVAB was 5%-29% (6,9,(11)(12)(13).…”

“…In general, SVAB removes larger number of cores compared with automated core biopsy devices. It has been shown that the underestimation rate is lower with increased number of cores (9,21). When more than 10 specimens per lesion are obtained, the underestimation rate of DCIS reduces significantly (9).…”

“…It has been shown that the underestimation rate is lower with increased number of cores (9,21). When more than 10 specimens per lesion are obtained, the underestimation rate of DCIS reduces significantly (9). On the other hand, Liberman et al (20) showed that, for larger lesions, underestimation inevitably occurs even when more that 40 core specimens were retrieved.…”

Ultra-sonografia mamária na identificação e orientação de biópsia percutânea das microcalcificações agrupadas

“…Estudos têm demonstrado diminuição das taxas de diagnósticos subestimados com este tipo de técnica (SIMON et al, 2000;JACKMAN et al, 2001). Jackman e colaboradores, em estudo multicêntrico, encontraram uma taxa de 20,4% de casos subestimados usando agulhas tradicionais, contra 11,2% utilizando a mamotomia.…”