Benign core biopsy of probably benign breast lesions 2 cm or larger: correlation with excisional biopsy and long-term follow-up

Jung, Hyun Hwan; Moon, Hee Jung; Kim, Min Jung

doi:10.14366/usg.14011

Cited by 12 publications

(8 citation statements)

References 24 publications

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“…Recently, Jung et al 18 reported that some growing masses on follow-up sonography, which had first been diagnosed as benign tumours by ultrasound-guided core biopsy, were confirmed as benign or malignant phyllodes tumours by subsequent excisional biopsy. In our series, 10 cases had been initially diagnosed as fibroadenoma by ultrasound-guided core biopsy and were finally confirmed as phyllodes tumours by complete removal (benign phyllodes tumour: 7/31, aggressive phyllodes tumour: 3/15).…”

Section: Discussionmentioning

confidence: 99%

Phyllodes Tumour of the Breast: Differentiation of Histological Grade by Ultrasonography

Shin

Park

et al. 2019

Hong Kong Journal of Radiology

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Objectives: To retrospectively evaluate whether benign and aggressive phyllodes tumours have distinguishing ultrasonographic features. Methods: We searched the breast imaging database for patients with diagnoses of phyllodes tumours between 2003 and 2014. The imaging studies of eligible patients were retrospectively reviewed. Results: A total of 46 patients (all women; mean age, 41.1 years; range, 20-69 years) were enrolled in the study. The histological grades were benign in 67.4% (n = 31), borderline in 23.9% (n = 11), and malignant in 8.7% (n = 4) of patients. The mean long-axis diameter of the tumour was 3.1 cm (range, 0.7-6.9 cm) in benign tumours and 5.8 cm (range, 3.0-13.0 cm) in aggressive tumours. As compared with benign phyllodes tumours, aggressive tumours showed larger long-axis diameter (p = 0.01), more frequently irregular shape (60% vs. 3.2%), indistinct or microlobulated margins (66.7% vs. 25.8%), and complex cystic and solid echogenicity (46.7% vs. 0%). Benign phyllodes tumours more commonly showed heterogeneous echogenicity with small anechoic clefts (54.8% vs. 20.0%). Conclusion: Several sonographic findings including long-axis diameter, shape, margin, and echogenicity were helpful to differentiate benign and aggressive phyllodes tumours. Irregular shape was a strong, independent predictor of aggressive phyllodes tumours.

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Section: Discussionmentioning

confidence: 99%

Phyllodes Tumour of the Breast: Differentiation of Histological Grade by Ultrasonography

Shin

Park

et al. 2019

Hong Kong Journal of Radiology

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“…Familiarity with the BI-RADS classification is a crucial step for correctly determining imaging–pathology similarity for all accessible modalities [ 11 , 13 ]. According to the new BI-RADS update, the likelihood of malignancy within category 4 (suspicious) ranges from 2 to 95% [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…When concern regarding a dissonant benign biopsy exists, immediate communication within the healthcare team about the discrepancy and best biopsy method is necessary [ 11 ]. On the other hand, the high-risk/borderline category is not malignant but presents a high lifetime malignancy risk along with the ongoing controversy of whether surgical or oncological treatment is the appropriate management [ 13 ]. According to the Mayo Clinic, a large cohort study found an accumulative risk of breast cancer development in those with high-risk lesions (such as ADH), and 25 years after the first biopsy, malignancy developed in 30% of the women with these lesions [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to the Mayo Clinic, a large cohort study found an accumulative risk of breast cancer development in those with high-risk lesions (such as ADH), and 25 years after the first biopsy, malignancy developed in 30% of the women with these lesions [ 2 ]. Management options should be individualized based on the patient’s overall status [ 13 ]. When ADH is identified on CNB, it carries a high risk of associated malignancy.…”

Section: Discussionmentioning

confidence: 99%

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Atypical ductal hyperplasia of the breast mimics breast cancer presentation treated surgically: a case report and literature review

Alwagdani

Alnefaie

Kurshid

et al. 2021

Journal of Surgical Case Reports

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Atypical ductal hyperplasia (ADH) is considered a benign lesion with increased malignant potential. ADH represents ~3% of total benign breast biopsy results. A 60-year-old woman with no family history of breast cancer presented with multiple painless lumps in the right breast and palpable right axillary lymph nodes. Ultrasonography and mammography showed typical features of breast cancer. However, core needle biopsy revealed ADH without infiltrating malignancy. Based on a multidisciplinary decision, a right simple mastectomy with sentinel lymph node biopsy was chosen as the best treatment plan. The postoperative histopathology report showed the spread of ductal carcinoma in situ (DCIS) in all quadrants without any evidence of invasive cancer. It is challenging to obtain an accurate diagnosis of clinically palpable and multicentric ADH or DCIS based on preoperative radiological and histological evaluation, especially when dissonance between these two evaluation modalities exists.

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“…A later study in 2005 with long-term follow-up reported a false-negative rate of 3.7% for 14-gauge US-guided CNB, with three delayed diagnoses of cancer occurring at the site of prior CNB [ 5 ]. However, recent studies published in the last decade have reported slightly lower false-negative rates of US-guided CNB, ranging from 0.1% to 2.5%, with most cases identified because of discordance between imaging results and CNB histologic findings ( Table 1 ) [ 7 - 11 , 14 , 15 ]. The reported underestimation rate of high-risk lesions through US-guided CNB, a category primarily composed of atypical ductal hyperplasia (ADH) lesions in most studies, ranges from 24.5% to 65% [ 7 , 8 , 10 , 16 ].…”

Section: Review Of Us-guided Breast Biopsymentioning

confidence: 99%

Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy

et al. 2018

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Ultrasound (US)-guided breast biopsy has become the main method for diagnosing breast pathology, and it has a high diagnostic accuracy, approaching that of open surgical biopsy. However, methods for confirming adequate lesion retrieval after US-guided biopsy are relatively limited and false-negative results are unavoidable. Determining imaging-pathology concordance after US-guided biopsy is essential for validating the biopsy result and providing appropriate management. In this review article, we briefly present the results of US-guided breast biopsy; describe general aspects to consider when establishing imaging-pathology concordance; and review the various categories of imaging-pathology correlations and corresponding management strategies.

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Benign core biopsy of probably benign breast lesions 2 cm or larger: correlation with excisional biopsy and long-term follow-up

Cited by 12 publications

References 24 publications

Phyllodes Tumour of the Breast: Differentiation of Histological Grade by Ultrasonography

Phyllodes Tumour of the Breast: Differentiation of Histological Grade by Ultrasonography

Atypical ductal hyperplasia of the breast mimics breast cancer presentation treated surgically: a case report and literature review

Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy

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