Comparison of stereotactic core breast biopsy and open surgical biopsy results at a tertiary care hospital in Pakistan

Masroor, Imrana; Afzal, Shaista; Shafqat, Gulnaz; Khattak, Yasir Jamil

doi:10.2147/ijwh.s22853

Cited by 3 publications

(4 citation statements)

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“…Fibroadenoma is a common benign tumor, resulting from an excess proliferation of connective tissue and is often subjected to percutaneous biopsy [28]. A study by Masroor et al showed that 80% of all biopsied breast lesions were benign in the Pakistani population [29]. This is similar to other studies, that have reported a cancer detection rate of only 10%-30% on breast biopsy [17].…”

Section: Discussionmentioning

confidence: 56%

Value of Elastography in Differentiating Benign from Malignant Breast Lesions Keeping Histopathology as Gold Standard

Farooq

Mubarak

Shaukat

et al. 2019

Cureus

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Background: Breast cancer is the most common cancer in females, both in developed and developing countries. Pakistan has the highest breast cancer incidence rate in Asia. Guidelines recommend screening for detecting breast cancer with mammography and ultrasonography (US). Shear-wave elastography (SWE) is a newer technique that can aid additional characterization of breast lesions. Objective: The aim of this study was to determine the diagnostic accuracy of breast ultrasound elastography in differentiating benign from malignant breast lesions using histology diagnosis as the gold standard.Materials and methods: The study was conducted at the Abbasi Shaheed Hospital and Jinnah Post Graduate Medical Centre, Karachi. All consecutive patients undergoing breast biopsy and elastography of breast lesions were enlisted; 2 x 2 tables were used to measure the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of breast ultrasound elastography for differentiation of benign from malignant breast masses.Results: A total of 155 female patients were included with a mean age of 45.41 ± 14.24 years (range 20-70 years). On histological evaluation, 115 (74.2%) lesions were malignant and 40 (25.8%) were benign. The overall average mean elastography value was 108.45 kPa ± 52.75. The mean elastography (EMean) value for benign breast lesions was 48.96 kPa ± 42.32 and 132.78 kPa ± 42.32 for malignant lesions. The difference in mean elastography values of benign and malignant breast lesions was statistically significant (48.96 kPa ± 42.32 vs 32.78 kPa ± 42.32, P <0.001). The area under the curve (AUC) was 0.952, optimal cutoff EMean value of 72 kPa and higher likelihood ratio was 9.41. A cutoff mean elastography (EMean) value of ≤ 72 kilopascal (kPa) for benign lesions had sensitivity 92.17%, specificity 90.4%, PPV 96.36%, NPV 80.0% and diagnostic accuracy 91.61%. Conclusion: Ultrasound elastography was found to have high sensitivity and specificity and diagnostic accuracy for differentiating benign from malignant breast lesions. Use of shear-wave elastography may increase malignancy detection rate by reducing the need for biopsy in benign breast lesions.

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Section: Discussionmentioning

confidence: 56%

Value of Elastography in Differentiating Benign from Malignant Breast Lesions Keeping Histopathology as Gold Standard

Farooq

Mubarak

Shaukat

et al. 2019

Cureus

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“…Furthermore, the biopsy results strongly influence the algorithm for evaluation of suspicious lesions. 16 …”

Section: Discussionmentioning

confidence: 99%

Usefulness of hook wire localization biopsy under imaging guidance for nonpalpable breast lesions detected radiologically

Masroor¹,

Afzal²,

Shafqat³

et al. 2012

IJWH

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BackgroundThe purpose of this study was to evaluate the usefulness of hook wire localization biopsy under imaging guidance for nonpalpable breast lesions detected radiologically.MethodsThis was a descriptive study conducted at the Department of Radiology, Aga Khan University Hospital, Karachi. All patients undergoing needle localization biopsy of a nonpalpable breast lesion under mammographic or ultrasound guidance between January 2009 to December 2010 were included in the study. Patients with incomplete medical records were excluded. All patients’ mammograms or ultrasound were categorized using BI-RADS® assessment categories. The percentages of benign and malignant lesions were determined by pathological examination of surgically removed specimens. A correlation was sought between preoperative imaging assessment and the final diagnosis. The complications associated with the procedure were also recorded.ResultsA total of 151 biopsies were carried out, of which 80 were performed under mammographic guidance and 71 were performed under ultrasound guidance. The mean age of the patients was 51.89 years. The overall malignancy rate was 25.16%. Of 93 cases reported radiologically as malignant, 60 turned out to be malignant, and of the 58 cases reported as benign on imaging, three proved to be malignant on histopathology. The sensitivity of imaging findings was 95% and the specificity was 62%. The malignancy rate was 5% for benign lesions and 64% for malignant lesions, respectively. There were no complications related to wire localization, and only two patients had minor complications following surgical excision, giving a complication rate of 1.32%.ConclusionHook wire localization biopsy is a safe and effective procedure for definitive diagnosis of suspicious lesions on imaging, and is more helpful if the imaging findings are suspicious.

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“…Most of all, surgery can place a large burden on patients. The morbidity, mortality and the cost in surgery have been discussed as disadvantage of surgery in previous study and wire localization is necessary for non-palpable lesions (3,21). If the wire inadvertently dislodges, migrates or is transected, the surgeon can become disoriented and excise the wrong tissue (22).…”

Section: Discussionmentioning

confidence: 99%

“…In particular, ST-VAB is a safe and effective method for nonpalpable mammographically visible microcalcifications or masses, and can yield large amounts of tissue (1)(2)(3)(4)(5). Furthermore, a lower re-biopsy rate and a fewer cases of histologic underestimation of ST-VAB with this method compared to core needle biopsy (CNB) were reported (5).…”

Section: Introductionmentioning

confidence: 99%

Vacuum Assisted-Biopsy and Mammo-Guided Localization and Excisional Biopsy in the Microcalcifications Sampling of Breast: An Experience of Single Institution

Park

Sohn

2016

Iran J Radiol

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Background: Sterotactic vacuum assisted biopsy (ST-VAB) is safe and effective method for nonpalpable mammographically visible microcalcifications or masses. ST-VAB is less invasive and is associated with less scar formation than surgical excision. Also ST-VAB can avoid unnecessary additional surgery. But ST-VAB has possibility of histologic underestimation of high-risk lesions such as atypical ductal hyperplasia and atypical lobular hyperplasia. Objectives: To evaluate the outcome of ST-VAB and mammography-guided localization and excisional biopsy (MGL-EB) for microcalcifications. Patients and Methods: Two radiologists retrospectively reviewed the medical records of patients who underwent breast biopsy for microcalcification from January 2011 to March 2013. They underwent ST-VAB (n = 22) and MGL-EB (n = 34). The clinicoradiological factors of two groups were evaluated, respectively. The malignancy rate and imaging histologic discordant rate in the two groups were assessed. We evaluated follow-up studies of all patients for newly developed or missed breast cancer. Results: The malignancy rates were 13.6% (3/22) for ST-VAB and 17.6% (6/34) for MGL-EB, respectively. Subsequent surgery was performed in five patients (n = 3, ST-VAB; n = 2, MGL-EB) and they were all confirmed as ductal carcinoma in situ. The discordant rates were 22.7 % (5/22) for ST-VAB and 14.7 % (5/34) for MGL-EB after imaging-histologic correlation. There was no malignancy detected on follow up studies. Conclusion: ST-VAB and MGL-EB are reliable biopsy methods for microcalcifications. In proper indications, breast microcalcifications could be obtained by each method without missing diagnosis of breast cancer.

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Comparison of stereotactic core breast biopsy and open surgical biopsy results at a tertiary care hospital in Pakistan

Cited by 3 publications

References 12 publications

Value of Elastography in Differentiating Benign from Malignant Breast Lesions Keeping Histopathology as Gold Standard

Value of Elastography in Differentiating Benign from Malignant Breast Lesions Keeping Histopathology as Gold Standard

Usefulness of hook wire localization biopsy under imaging guidance for nonpalpable breast lesions detected radiologically

Vacuum Assisted-Biopsy and Mammo-Guided Localization and Excisional Biopsy in the Microcalcifications Sampling of Breast: An Experience of Single Institution

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