Imaging-histologic discordance at sonographically guided percutaneous biopsy of breast lesions

Kim, Min Jung; Park, Sun Young; Jung, Haejoon; Park, Byeong Woo; Kim, Haeryung; Oh, Ki Keun

doi:10.1016/j.ejrad.2007.03.016

Cited by 9 publications

(6 citation statements)

References 16 publications

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“…Liberman et al ( 10 ) reported that 10.5% (2/19) of their results were immediate false negatives under US-guidance during a 7-year period. Their upgrade rate to malignancy (10.5%) was higher than our upgrade rate (4.6%), though these two results are almost within the previously reported range (6.8-29.3%) ( 1 , 6 , 10 , 12 , 13 , 14 , 15 ). Imaging-histologic discordance tends to be determined by the radiologist's experience rather than by well-established criteria.…”

Section: Discussionsupporting

confidence: 62%

“…We focused only on the VAR indication in cases of imaging-histologic discordance after 14-gauge CNB but we did not include high risk lesions, as in Rajan et al ( 18 ). Many studies ( 1 , 6 , 9 , 10 , 12 , 13 , 15 , 19 ) have reported the role of VAR; however, they included all VAR cases, not just those that were imaging-histologic discordant. Son et al ( 1 ) performed VAR in 53 lesions among 103 imaging-histologic discordant cases, but we included a larger study population with discordant results ( 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…We evaluated the difference in upgrade rates between VAR and surgical excision and the role of VAR as a rebiopsy method for imaging-histologic discordant lesions after US-guided CNB with long-term follow-up results. The upgrade rate in the imaging-histologic discordant lesions after VAR or surgical excision has been reported to be 6.8-29.3% ( Table 4 ) ( 1 , 6 , 10 , 12 , 13 , 14 , 15 ). The upgrade rates in our study were 4.6% and 24.6% for VAR and surgical excision, respectively, which is similar to the range reported previously.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound (US)-guided core needle biopsy (CNB) is an accurate and standard method for sampling lesions that are visible on US ( 1 ). However, CNB may underestimate results ( 2 , 3 ) or produce false-negative results ( 4 , 5 ), and various factors can affect CNB accuracy ( 6 ). Therefore, many solutions have been suggested, including confirmation of lesion retrieval by specimen radiography, correlating post-biopsy imaging and histology, larger sampling for imaging-histologic discordant lesions, and follow-up after benign biopsy results ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

“…The frequency of imaging-histologic discordance has been reported to be 1-6%, and several studies have reported imaging-histologic discordance following stereotactic CNB ( 4 , 8 , 9 ) and US-guided CNB ( 1 , 6 , 8 , 10 , 11 , 12 ). These reports show malignancy rates of 6.8-29.3% in imaging-histologic discordant lesions during US-guided biopsy ( 1 , 6 , 10 , 12 , 13 , 14 , 15 ), suggesting that rebiopsy of those lesions will yield benign pathology in approximately 70.7-93.2% of cases. Considering the large percentage of benign pathology at rebiopsy, Kim et al ( 12 ) used vacuum-assisted removal (VAR) on discordant cases for a definitive diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Ultrasound-Guided Vacuum-Assisted Removal versus Surgery for Breast Lesions Showing Imaging-Histology Discordance after Ultrasound-Guided Core-Needle Biopsy

et al. 2014

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ObjectiveTo evaluate the upgrade rate and delayed false-negative results of percutaneous vacuum-assisted removal (VAR) and surgical excision in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy (CNB) of the breast and to validate the role of VAR as a rebiopsy method for these discordant lesions.Materials and MethodsPercutaneous US-guided 14-gauge CNB was performed on 7470 patients between August 2005 and December 2010. Our study population included 161 lesions in 152 patients who underwent subsequent rebiopsy due to imaging-histologic discordance. Rebiopsy was performed using VAR (n = 88) or surgical excision (n = 73). We investigated the upgrade rate immediately after rebiopsy and delayed false-negative results during at least 24 months of follow-up after rebiopsy. We also evaluated the clinicoradiological differences between VAR and surgical excision.ResultsTotal upgrade to malignancy occurred in 13.7% (22/161) of lesions at rebiopsy including both VAR and surgical excision: 4.6% (4/88) of VAR cases (4/88) and 24.7% (18/73) of surgical excision cases (p < 0.001). Surgical excision was performed significantly more frequently in older patients and for larger-sized lesions than that of VAR, and a significant difference was detected between VAR and surgical excision in the Breast Imaging and Reporting and Data System category (p < 0.007). No delayed false-negative results were observed after VAR or surgical excision during the follow-up period.ConclusionLong-term follow-up data showed no delayed cancer diagnoses after US-guided VAR in imaging-histologic discordant lesions of the breast, suggesting that VAR might be a rebiopsy method for these lesions.

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