One Operation After Percutaneous Diagnosis of Nonpalpable Breast  Cancer

Liberman, Laura; Goodstine, Shelley L.; Dershaw, D. David; Morris, Elizabeth A.; LaTrenta, Linda R.; Abramson, A F; Zee, Kimberly J. Van

doi:10.2214/ajr.178.3.1780673

Cited by 42 publications

(16 citation statements)

References 31 publications

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“…Lesions diagnosed as DCIS on needle biopsy and unsuspected invasive carcinoma at surgery result in delayed lymph node biopsies. Thus, patients may have to undergo two separate surgical procedures: one procedure for excision of the lesion and an additional procedure for axillary lymph node evaluation [16]. …”

Section: Discussionmentioning

confidence: 99%

Ductal carcinoma in situ diagnosed using an ultrasound-guided 14-gauge core needle biopsy of breast masses: can underestimation be predicted preoperatively?

Park

Kim

2014

Ultrasonography

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Purpose:This study was designed to determine the rate of ductal carcinoma in situ (DCIS)underestimation diagnosed after an ultrasound-guided 14-gauge core needle biopsy (US-14G-CNB) of breast masses and to compare the clinical and imaging characteristics between trueDCIS and underestimated DCIS identified following surgical excision.Methods:Among 3,124 US-14G-CNBs performed for breast masses, 69 lesions in 60 patients were pathologically-determined to be pure DCIS. We classified these patients according to the final pathology after surgical excision as those with invasive ductal carcinoma (underestimated group) and those with DCIS (non-underestimated group). We retrospectively reviewed and compared the clinical and imaging characteristics between the two groups.Results:Of the 69 lesions, 21 were shown after surgery to be invasive carcinomas; the rateof DCIS underestimation was 30.4%. There were no statistically significant differences withrespect to the clinical symptoms, age, lesion size, mammographic findings, and ultrasonographic findings except for the presence of abnormal axillary lymph nodes as detected on ultrasound. The lesions in 2 patients in the non-underestimated group (2/41, 4.9%) and 5 patients in the underestimated group (5/19, 26.3%) were associated with abnormal lymph nodes on axillary ultrasound, and the presence of abnormal axillary lymph nodes on ultrasound was tatistically significant (P=0.016).Conclusion:We found a 30.4% rate of DCIS underestimation in breast masses based on a US-14G-CNB. The presence of abnormal lymph nodes as detected on axillary ultrasound may be useful to preoperatively predict underestimation.

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Section: Discussionmentioning

confidence: 99%

Ductal carcinoma in situ diagnosed using an ultrasound-guided 14-gauge core needle biopsy of breast masses: can underestimation be predicted preoperatively?

Park

Kim

2014

Ultrasonography

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“…12 The accurate percutaneous diagnosis of breast cancer facilitates preoperative planning, often enabling surgical treatment of breast cancer in one operation. 13,14 Previous reports of image-guided large-core needle biopsy (LCNB), mostly using a prone stereotactic guidance technique, have shown that the procedure's accuracy is similar to that of surgical excision. [1][2][3][4][5][6][15][16][17] Sonographically guided Abbreviations: Ca, Carcinoma; DCIS, ductal carcinoma in situ.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of sonographically guided 14-gauge core-needle biopsy: Results of 715 consecutive breast biopsies with at least two-year follow-up of benign lesions

Crystal

Koretz

Shcharynsky

et al. 2005

J. Clin. Ultrasound

107

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“…As noted previously, there are advantages to proceeding with an image-guided percutaneous needle biopsy as the initial diagnostic strategy. Patients whose diagnosis pf cancer has been made by needle biopsy are more likely to have successful breast-conservation therapy and to require fewer re-excisions for margin control than patients who undergo an initial open biopsy for diagnostic purposes [72]. A core-needle biopsy is preferable to a fine-needle aspiration biopsy because he larger tissue yield can distinguish in situ from invasive architecture and also because the sampling error with a fine-needle aspiration biopsy can be as high as 30%, compared with only 5% to 10% with a core needle.…”

Section: Sampling Errormentioning

confidence: 99%

Complications in Breast Surgery

Vitug

Newman

2007

Surgical Clinics of North America

156

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The breast is a relatively clean organ comprised of skin, fatty tissue, and mammary glandular elements that have no direct connection to any major body cavity or visceral structures. In the absence of concurrent major reconstruction, breast surgery generally is not accompanied by large-scale fluid shifts, infectious complications, or hemorrhage. Thus, most breast operations are categorized as low-morbidity procedures. Because the breast is the site of the most common cancer afflicting American women, however, a variety of complications can occur in association with diagnostic and multidisciplinary management procedures. Some of these complications are related to the breast itself, and others are associated with axillary staging procedures. This article first addresses some general, nonspecific complications (wound infections, seroma formation, hematoma). It then discusses complications that are specific to particular breast-related procedures: lumpectomy (including both diagnostic open biopsy and breast-conservation therapy for cancer), mastectomy; axillary lymph node dissection (ALND), lymphatic mapping/sentinel lymph node biopsy, and reconstruction. Complications related to reconstruction are discussed in a separate article in this issue. General wound complications related to breast and axillary surgeryBecause it is a peripheral soft tissue organ, many wound complications related to breast procedures are relatively minor and frequently are managed on an outpatient basis. It therefore is difficult to establish accurate incidence rates for these events. As discussed later, however, reported studies

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One Operation After Percutaneous Diagnosis of Nonpalpable Breast Cancer

Cited by 42 publications

References 31 publications

Ductal carcinoma in situ diagnosed using an ultrasound-guided 14-gauge core needle biopsy of breast masses: can underestimation be predicted preoperatively?

Ductal carcinoma in situ diagnosed using an ultrasound-guided 14-gauge core needle biopsy of breast masses: can underestimation be predicted preoperatively?

Accuracy of sonographically guided 14-gauge core-needle biopsy: Results of 715 consecutive breast biopsies with at least two-year follow-up of benign lesions

Complications in Breast Surgery

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