Paradigm Shifts in Breast Care Delivery: Impact of Imaging in a Multidisciplinary Environment

Krishnamurthy, Savitri; Bevers, Therese B.; Kuerer, Henry Mark; Smith, Benjamin D.; Yang, Wei Tse

doi:10.2214/ajr.16.17130

Cited by 14 publications

(3 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…14 For example, a pathological diagnosis of atypical ductal hyperplasia in a small lesion that was nearly entirely removed by vacuum-assisted biopsy may not require subsequent surgical resection. 15 On the other hand, if the same pathological diagnosis of atypical ductal hyperplasia was obtained with imaging showing extensive suspicious findings, there was a high possibility of co-existing higher-grade lesions and further surgical excision would be justified. Therefore, a single-standard approach does not exist for high-risk breast lesions and individualised management should be offered.…”

Section: Imaging Findings In Patients With Postproceduralmentioning

confidence: 99%

Analysis of Discordant Histologically Benign Breast Lesions and Predictive Factors Associated with True Discordance on Imaging

Wan,

Chu,

Chin

et al. 2024

Hong Kong Journal of Radiology

View full text Add to dashboard Cite

Introduction: Discordant benign breast lesions are suspicious for malignancy on imaging but show benign histology on initial biopsy. These lesions require further histological workup. This study sought to determine the frequency of discordant benign lesions and the rate of true discordance among them, and to identify predictive factors associated with true discordance. Methods: Clinical, radiological, and pathological data on all discordant benign breast lesions biopsied between 2012 and 2021 were retrieved from the departmental database of a Hong Kong hospital. Rate of discordant benign lesions, true and false discordance rates, and proportion of high-risk and benign lesions among false discordance were calculated. If the discordant benign lesion was found to be malignant in repeat percutaneous biopsy or excisional biopsy, it was true discordance. If a lesion's benignity was confirmed with excisional biopsy, it was false discordance. Univariate analysis was performed followed by multivariable logistic regression analysis to identify independent predictors associated with true discordance. Results: A total of 3080 breast biopsies were performed during the study period, of which 64 lesions (2.1%) were discordant benign lesions. Among 55 lesions with available additional workup results, 17 lesions (30.9%) were true discordant and 38 (69.1%) were false discordant. Nine (23.7%) of the false discordant lesions were high-risk lesions on final pathology. Older age (p = 0.019), presence of symptoms (p = 0.046), BI-RADS category 5 (p = 0.028), presence of microcalcifications with suspicious morphology (p = 0.047), and presence of architectural distortion (p = 0.04) were identified as independent predictors of true discordance. Conclusion:The high true discordance rate confirmed the importance of further histological workup in discordant benign breast lesions.

show abstract

Section: Imaging Findings In Patients With Postproceduralmentioning

confidence: 99%

Analysis of Discordant Histologically Benign Breast Lesions and Predictive Factors Associated with True Discordance on Imaging

Wan,

Chu,

Chin

et al. 2024

Hong Kong Journal of Radiology

View full text Add to dashboard Cite

show abstract

“…This trend to de-escalate treatment with complete removal of the lesion by VAB has been expanding to other histological diagnosis with uncertain malignant potential and may be appropriate for selected cases of flat epithelial atypia, classic lobular neoplasia, radial scar, and benign phyllodes tumor [15,16].…”

Section: Therapeutic Vabmentioning

confidence: 99%

Image-Guided Percutaneous Biopsies

Zanetta

2021

Modern Breast Cancer Imaging

View full text Add to dashboard Cite

“…A thorough review and discussion of clinical and imaging findings, biopsy characteristics including the biopsy method and degree of removal, pathological findings including the extent of the lesion, and associations between clinical and pathological features and imaging can lead to personalized management recommendations [ 64 , 66 ]. For example, a diagnosis of focal ADH on pathology in a small lesion that has been nearly completely removed by vacuum-assisted biopsy may result in a recommendation of imaging follow-up [ 66 ]. In contrast, a finding of extensive high-risk disease in a lesion with limited sampling has a higher possibility of co-existing higher-grade lesions, and surgical excision may be recommended.…”

Section: Categories Of Imaging-pathology Concordancementioning

confidence: 99%

Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy

et al. 2018

View full text Add to dashboard Cite

Ultrasound (US)-guided breast biopsy has become the main method for diagnosing breast pathology, and it has a high diagnostic accuracy, approaching that of open surgical biopsy. However, methods for confirming adequate lesion retrieval after US-guided biopsy are relatively limited and false-negative results are unavoidable. Determining imaging-pathology concordance after US-guided biopsy is essential for validating the biopsy result and providing appropriate management. In this review article, we briefly present the results of US-guided breast biopsy; describe general aspects to consider when establishing imaging-pathology concordance; and review the various categories of imaging-pathology correlations and corresponding management strategies.

show abstract

Paradigm Shifts in Breast Care Delivery: Impact of Imaging in a Multidisciplinary Environment

Cited by 14 publications

References 71 publications

Analysis of Discordant Histologically Benign Breast Lesions and Predictive Factors Associated with True Discordance on Imaging

Analysis of Discordant Histologically Benign Breast Lesions and Predictive Factors Associated with True Discordance on Imaging

Image-Guided Percutaneous Biopsies

Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy

Contact Info

Product

Resources

About