Imaging–histologic discordance at percutaneous breast biopsy

Liberman, Laura; Drotman, Michele; Morris, Elizabeth A.; LaTrenta, Linda R.; Abramson, A F; Zakowski, Maureen F.; Dershaw, D. David

doi:10.1002/1097-0142(20001215)89:12<2538::aid-cncr4>3.0.co;2-#

Cited by 175 publications

(106 citation statements)

References 36 publications

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“…It has been thought that histological DCIS underestimation is a problem often encountered when microcalcification is biopsied under ultrasound guidance [17,[28][29]. Despite the high percentage of microcalcification lesions in the VAB group, we found a lower DCIS underestimation rate in this group than that in the ACNB group.…”

Section: Discussioncontrasting

confidence: 62%

Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 8- or 11-gauge vacuum-assisted biopsy

Suh¹,

Kim²,

Kim³

et al. 2012

The British Journal of Radiology

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Objective: The objective of this study was to compare the underestimation rate of invasive carcinoma in cases with ductal carcinoma in situ (DCIS) at percutaneous ultrasound-guided core biopsies of breast lesions between 14-gauge automated coreneedle biopsy (ACNB) and 8-or 11-gauge vacuum-assisted biopsy (VAB), and to determine the relationship between the lesion type (mass or microcalcification on radiological findings) and the DCIS underestimation rate. Methods: We retrospectively reviewed imaging-guided biopsies of breast lesions performed from February 2003 to August 2008. 194 lesions were diagnosed as DCIS at ultrasound-guided core biopsy: 138 lesions in 132 patients by 14-gauge ACNB, and 56 lesions in 56 patients by 8-or 11-gauge VAB. The histological results of the core biopsy samples were correlated with surgical specimens. The clinical and radiological findings were also reviewed. The histological DCIS underestimation rates were compared between the two groups and were analysed for differences according to the clinical and radiological characteristics of the lesions. Results: The DCIS underestimation rate was 47.8% (66/138) for 14-gauge ACNB and 16.1% (9/56) for VAB (p,0.001). According to the lesion type on sonography, DCIS underestimation was 43.4% (63/145) in masses (47.6% using ACNB and 15.8% using VAB; p50.012) and 24.5% (12/49) in microcalcifications (50.0% using ACNB and 16.2% using VAB; p50.047). Conclusion:The underestimation rate of invasive carcinoma in cases with DCIS at ultrasound-guided core biopsies was significantly higher for ACNB than for VAB. Furthermore, this difference does not change according to the lesion type on ultrasound. Therefore, ultrasound-guided VAB can be a useful method for the diagnosis of DCIS lesions presented as either mass or microcalcification.

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Section: Discussioncontrasting

confidence: 62%

Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 8- or 11-gauge vacuum-assisted biopsy

Suh¹,

Kim²,

Kim³

et al. 2012

The British Journal of Radiology

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“…In stereotactic biopsy, the reported imaging-histologic discordance rate ranges from 3.1 to 6.2%. When the subsequent procedure (surgical excision or repeat biopsy) has been performed at the discordant lesion after stereotactic biopsy, the frequency of malignancy ranged from 0 to 64% (7,20,(23)(24)(25). In this study, imaging histologic discordance of ST-VAB is 22.7%.…”

Section: Discussionmentioning

confidence: 64%

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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“…The analysis of concordance was not straightforward. We initially sought to investigate imaging-histologic correlation in lung biopsy cases with the intent of emphasizing discordance as a method to prospectively identify missed carcinomas, as is done in breast imaging (8,(10)(11)(12)(13). However, we found that radiology reports varied significantly in diagnostic coverage and clarity depending on a radiologist's personal style, an observation also reported in the literature (20,21).…”

Section: Discussionmentioning

confidence: 99%

“…In mammography, with the adoption of the Breast ImagingReporting and Data System (BI-RADS), this notion of discordance fits naturally due to strict, unambiguous radiologic guidelines governing diagnostic conclusions. BI-RADS provides a framework that allows instances of discordance to receive special consideration such that ostensibly negative pathology in cases of high radiographic suspicion warrant prompt repeat biopsy (10)(11)(12)(13)(14).…”

mentioning

confidence: 99%

Imaging–Histologic Discordance at Percutaneous Biopsy of the Lung

Arnold

Vangala

et al. 2015

Academic Radiology

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Rationale and Objectives: The purpose of this study was to quantify the degree of imaging-histologic discordance in a cohort of patients undergoing computed tomography (CT)-guided lung biopsy for focal lung disease. Materials and Methods:A retrospective review was performed of 186 patients who underwent percutaneous lung biopsy of a parenchymal lesion at our institution between January and December 2009. Diagnostic radiology reports of CT or positron emission tomography-CTs performed before biopsy were used to classify the lesion as malignant or benign by five readers. Pathology reports of the biopsied lesions were classified by three readers. Inter-reader agreement and imaging-histologic concordance were quantified using kappa statistics. Discordant benign cases were then revisited to determine downstream effects.Results: Inter-reader agreement on report content was substantial or almost perfect with kappas >0.783. Kappas for concordance were as follows: malignant (0.448), primary lung cancer (0.517), metastatic disease to lung (0.449), benign (0.510), and overall agreement (0.381). Of the twelve discordant benign cases that were revisited, four were found to be false negatives, resulting in a delay in diagnosis.Conclusions: Our study of imaging-histologic discordance in percutaneous biopsy of lung lesions supports the need for imaging report standardization and improved integration and communication between the fields of radiology and pathology.

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Imaging–histologic discordance at percutaneous breast biopsy

Cited by 175 publications

References 36 publications

Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 8- or 11-gauge vacuum-assisted biopsy

Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 8- or 11-gauge vacuum-assisted biopsy

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

Imaging–Histologic Discordance at Percutaneous Biopsy of the Lung

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