Image-Guided Breast Interventions: Biopsy and Beyond

Dhamija, Ekta; Singh, Rashmi; Mishra, Seema; Hari, Smriti

doi:10.1055/s-0041-1734223

Cited by 10 publications

(10 citation statements)

References 73 publications

(80 reference statements)

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“…Additional imaging procedures such as ultrasound, MRI, or additional mammographic images were ordered if necessary. All physicians were specialized in multimodality breast imaging and certified by the MIBB to perform VAB [23, 24]. All imaging examinations and biopsies were performed using current quality standards in accordance with national and international practice guidelines [22, 23].…”

Section: Methodsmentioning

confidence: 99%

“…All examinations were read and classified according to the American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BI-RADS) lexicon [25,26]. For indeterminate or suspicious breast lesions (BI-RADS IV and V) on ultrasound, tomosynthesis/mammography, or MRI-VAB was performed using the imaging modality that best depicted the suspicious lesion [23,24,27,28]. All biopsies were performed with modern, fully automated biopsy devices with a needle size of at least 12 (7)(8)(9)(10)(11)(12) gauge.…”

Section: Study Design and Patient Cohortmentioning

confidence: 99%

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Long-Term Follow-Up of High-Risk Breast Lesions at Vacuum-Assisted Biopsy without Subsequent Surgical Resection

Elfgen,

Varga,

Breitling

et al. 2023

Breast Care

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Introduction: B3-lesions of the breast are a heterogeneous group of neoplasms, associated with a higher risk of breast cancer. Recent studies show a low upgrade rate into malignancy after subsequent open surgical excision (OE) of most B3-lesions when proven by vacuum-assisted biopsy (VAB). However, there is a lack of long-term follow-up data after VAB of high-risk lesions. The primary aim of this study was to demonstrate whether follow-up of B3 lesions is a beneficial and reliable alternative to OE in terms of long-term outcome. The secondary aim was to identify patient and lesion characteristics of B3 lesions for which OE is still necessary. Methods: This retrospective multicenter study was conducted at 8 Swiss breast centers between 2010 and 2019. A total of 278 women (mean age: 53.5 ± 10.7 years) with 286 B3-lesions who had observation only and who had at least 24 months of follow-up were included. Any event during follow-up (ductal carcinoma in situ [DCIS], invasive cancer, new B3-lesion) was systematically recorded. Data from women who had an event during follow-up were compared with those who did not. The results for the different B3 lesions were analyzed using the t test and Fisher’s exact test. A p value of <0.05 was considered statistically significant. Results: The median follow-up interval was 59 months (range: 24–143 months) with 52% (148/286) having a follow-up of more than 5 years. During follow-up, in 42 women, 44 suspicious lesions occurred, with 36.4% (16/44) being invasive cancer and 6.8% (3/44) being DCIS. Thus, 6.6% (19/286) of all women developed malignancy during follow-up after a median follow-up interval of 6.5 years (range: 31–119 months). The initial histology of the B3 lesion influenced the subsequent occurrence of a malignant lesion during follow-up (p < 0.038). The highest malignancy-developing rate was observed in atypical ductal hyperplasia (ADH) (24%, 19/79), while all other B3-lesions had malignant findings ipsi- and contralateral between 0% and 6%. The results were not influenced by the VAB method (Mx-, US-, magnetic resonance imaging-guided), the radiological characteristics of the lesion, or the age or menopausal status of the patient (p > 0.12). Conclusion: With a low risk of <6% of developing malignancy, VAB followed by long-term follow-up is a safe alternative to OE for most B3-lesions. A higher malignancy rate only occurred in ADH (24%). Based on our results, radiological follow-up should be bilateral, preferable using the technique of initial diagnosis. As we observed a late peak (6–7 years) of breast malignancies after B3-lesions, follow-up should be continued for a longer period (>10 years). Knowledge of these long-term outcome results will be helpful in making treatment decisions and determining the optimal radiological follow-up interval.

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Section: Methodsmentioning

confidence: 99%

Section: Study Design and Patient Cohortmentioning

confidence: 99%

Long-Term Follow-Up of High-Risk Breast Lesions at Vacuum-Assisted Biopsy without Subsequent Surgical Resection

Elfgen,

Varga,

Breitling

et al. 2023

Breast Care

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“…Ablative treatments can also represent a palliative ablation for larger lesions (Figure 6) as well as an alternative therapy for those patients who are not suitable for surgery or refuse resection and/or other treatment modalities (such as chemotherapy) for cosmetic reasons [25,26].…”

Section: Locoregional Approachesmentioning

confidence: 99%

Emerging Indications for Interventional Oncology: Expert Discussion on New Locoregional Treatments

Iezzi

Gangi

Posa

et al. 2023

Cancers

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Interventional oncology (IO) employs image-guided techniques to perform minimally invasive procedures, providing lower-risk alternatives to many traditional medical and surgical therapies for cancer patients. Since its advent, due to rapidly evolving research development, its role has expanded to encompass the diagnosis and treatment of diseases across multiple body systems. In detail, interventional oncology is expanding its role across a wide spectrum of disease sites, offering a potential cure, control, or palliative care for many types of cancer patients. Due to its widespread use, a comprehensive review of the new indications for locoregional procedures is mandatory. This article summarizes the expert discussion and report from the “MIOLive Meet SIO” (Society of Interventional Oncology) session during the last MIOLive 2022 (Mediterranean Interventional Oncology Live) congress held in Rome, Italy, integrating evidence-reported literature and experience-based perceptions. The aim of this paper is to provide an updated review of the new techniques and devices available for innovative indications not only to residents and fellows but also to colleagues approaching locoregional treatments.

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“…Therefore, it is suggested that an accuracy of 99% can be achieved by taking at least 4 to 5 samples during CNB, while other researchers believe that multi-point puncture has no significant effect on diagnosis. [7][8][9][10] It is also believed that false negative rate is different among different pathological types. For example, ultrasound findings of in situ and highly differentiated carcinomas are atypical and classified as BI-RADS grade 3, resulting in missed diagnosis.…”

Section: Presented Approach Demonstrates a Potential To Improve Breas...mentioning

confidence: 99%

“…Previous studies are mainly focused on how to improve the accuracy of lesions above grade 3 in BI-RADS classification using ultrasound technology. [6][7][8][9][10] When necessary, hormone-dependent tumor markers such as estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER)-2 are also considered. [11] In addition, histological structure and morphological characteristics also determine the ultrasonographic manifestations of tumors, which are closely related to the occurrence, development, metastasis and recurrence of breast cancer.…”

Section: Introductionmentioning

confidence: 99%

The diagnostic value of BI-RADS grade 3 to 5 for breast masses is correlated with the expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2

He¹,

Shi

Luo³

et al. 2023

Medicine

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Background: The breast imaging-reporting and data system (BI-RADS) grading has a great advantage in diagnosing breast diseases, but with some limitations. Aims: The study analyzed the value of ultrasound-guided core needle biopsy (CNB) in diagnosing BI-RADS grades 3, 4, and 5 breast cancer. Methods: Breast cancer patients at BI-RADS grades 3 to 5 received breast ultrasonography, ultrasound-guided CNB and immunohistochemical examination. Receiver operating characteristic (ROC) curve was made to test diagnostic efficiency of regression model. Results: Calcification was positively correlated with expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER)-2. The areas of 4 ROC curves were 0.752, 0.805, 0.758, and 0.847, and the 95%CI was 0.660 to 0.844, 0.723 to 0.887, 0.667 to 0.849, and 0.776 to 0.918, respectively. BI-RADS grades 3 to 5 were positively correlated with expression of ER, PR and human epidermal growth factor receptor-2 (HER-2). Statistical significance existed between grade 5 and expression of ER, PR and HER-2, and between grade 4 and expression of HER-2. Conclusions: The study demonstrates that BI-RADS can be used as an effective evaluation method in the diagnosis of breast diseases before invasive operation, and it has higher diagnostic accuracy if combined with pathological examinations.

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Image-Guided Breast Interventions: Biopsy and Beyond

Cited by 10 publications

References 73 publications

Long-Term Follow-Up of High-Risk Breast Lesions at Vacuum-Assisted Biopsy without Subsequent Surgical Resection

Long-Term Follow-Up of High-Risk Breast Lesions at Vacuum-Assisted Biopsy without Subsequent Surgical Resection

Emerging Indications for Interventional Oncology: Expert Discussion on New Locoregional Treatments

The diagnostic value of BI-RADS grade 3 to 5 for breast masses is correlated with the expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2

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