Underestimation of breast cancer in intraductal papillomas treated with vacuum-assisted core needle biopsy

Hodorowicz-Zaniewska, Diana; Siarkiewicz, Benita; Brzuszkiewicz, Karolina; Szpor, Joanna

doi:10.5603/gp.2019.0022

Cited by 8 publications

(3 citation statements)

References 29 publications

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“…The data suggested that excision biopsies are not needed for most of these borderline changes as well. Furthermore, we noticed that B3 high frequently occurred in the range of BI-RADS-US 3-4b, which is partly consistent with the reports [ 31 , 32 ]. And the data showed that the most often underrated B3 subtypes were PL/ADH (50%), ADH (23.1%), and CSL/RS (16.7%), respectively.…”

Section: Discussionsupporting

confidence: 92%

Breast lesions excised via vacuum-assisted system: could we get any clues for B3 lesions before excision biopsy?

Zheng

Xing

et al. 2021

BMC Cancer

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Background The purpose of this study was to determine the validity of the ultrasound features as well as patient characteristics assigned to B3 (uncertain malignant potential) breast lesions before vacuum-assisted excision biopsy (VAEB). Methods This study population consisted of 2245 women with breast-nodular abnormalities, which were conducted ultrasound-guided VAEB (US-VAEB). Patient’s clinical and anamnestic data and lesion-related ultrasonic feature variables of B3 captured before US-VAEB were compared with those of benign or malignant cases, using histopathological results as a benchmark. Results The proportions of benign, B3 and malignant breast lesions diagnosed post-US-VAEB were 88.5, 8.2 and 3.4% respectively. B3 high frequent occurred in BI-RADS-US grade 3 (7.7%), grade 4a (11.0%) and grade 4b (9.1%). The overall malignancy underestimation rate of B3 was 4.4% (8/183). Malignant lesions were found mostly in the range of BI-RADS grade 4b (27.3%), grade 4c (33.3%) and grade 5 (100%). Multivariate binary logistic regression analyses (B3 vs benign) showed that non-menopausal patients (95% CI 1.628–8.616, P = 0.002), single (95% CI 1.370–2.650, P = 0.000) or vascularity (95% CI 1.745–4.150, P = 0.000) nodules in ultrasonic features were significant risk factors for B3 occurrences. In addition, patients elder than 50 years (95% CI 3.178–19.816, P = 0.000), unclear margin (95% CI 3.571–14.119, P = 0.000) or suspicious calcification (95% CI 4.010–30.733, P = 0.000) lesions were significantly associated with higher risks of malignant potentials for B3 cases (malignant vs B3). Conclusion The results of this study indicate that ultrasound findings and patients’ characteristics might provide valuable information for distinguishing B3 lesions from benign breast abnormalities before VAEB, and help to reduce malignancy underestimation of B3.

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Section: Discussionsupporting

confidence: 92%

Breast lesions excised via vacuum-assisted system: could we get any clues for B3 lesions before excision biopsy?

Zheng

Xing

et al. 2021

BMC Cancer

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“…The data suggested that excision biopsies are not needed for most of these borderline changes as well. Furthermore, we noticed that B3 high frequent occurred in the range from BI-RADS-US 3 to BI-RADS-US 4b, which is partly consistent with the reports [31,32]. And the data showed that the most underrated B3 subtypes for malignancies were PL/ADH (50%), ADH (23.1%), and CSL/RS (16.7%), respectively.…”

Section: Discussionsupporting

confidence: 88%

Breast lesions excised via Vacuum-Assisted System: Could We Get Any Clues for B3 Lesions Before Excision Biopsy?

Zheng

Xing

et al. 2021

Preprint

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Background: The purpose of this study was to determine the validity of the ultrasound features as well as patient characteristics assigned to B3 (uncertain malignant potential) breast lesions before vacuum-assisted excision biopsy (VAEB).Methods: This study population consisted of 2245 women with breast-nodular abnormalities, which were conducted ultrasound-guided VAEB (US-VAEB). Patient’s clinical and anamnestic data and lesion-related ultrasonic feature variables of B3 were compared with those of benign or malignant cases, using histopathological results as a benchmark. Results: The proportions of benign, B3 and malignant breast lesions were 88.5%, 8.2% and 3.4% respectively. B3 high frequent occurred in BI-RADS-US grade 3 (7.7%), grade 4 (9.3%), grade 4a (11.3%) and grade 4b (9.1%). The overall malignancy underestimation rate of B3 cases was 4.4% (8/183). The more common malignancy underestimation of B3 subtypes were PL/ADH 50% (1/2), ADH 23.1% (3/13), and CSL/RS 16.7% (1/6). And the highly frequent recurrence rates of B3 subtypes were ADH 10% (1/10), PL 4.9% (4/82), and PT 8.6% (6/70). Multivariate binary logistic regression analyses (B3 vs benign) showed that non-menopausal patients (95% CI 1.628-8.616, P = 0.002), single (95% CI 1.370-2.650, P = 0.000) or abundant blood supply (95% CI 1.745-4.150, P = 0.000) nodules via ultrasound examination were significant risk factors for B3 occurrences. Moreover, patients elder than 50 years (95% CI 3.178-19.816, P = 0.000), unclear margin (95% CI 3.571-14.119, P = 0.000) or microcalcification (95% CI 4.010-30.733, P = 0.000) nodules were significantly associated with higher risks of malignant potentials (B3 vs malignant).Conclusion: The results of this study indicate that ultrasound findings and patients’ characteristics could provide valuable information for distinguishing B3 cases from benign or malignant cases before VAEB.

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“…Some researchers have expressed concerns regarding the accuracy of preoperative VABB for determining the pathological characteristics of breast diseases ( 19 , 20 ). Therefore, we compared the pathological findings between the excised and residual tumors ( Table 4 ).…”

Section: Resultsmentioning

confidence: 99%

Reconsidering the therapeutic use for vacuum-assisted breast biopsy in breast cancer patients: a retrospective single-center study

Zhao¹,

Wang²,

Xü³

et al. 2020

Transl Cancer Res TCR

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Background The management of breast cancer has evolved over the last few decades, with needle biopsy interventions now including vacuum-assisted breast biopsy (VABB). Previous studies have examined the utility of VABB for diagnosing breast diseases, although it remains unclear whether VABB is safe and effective for breast cancer. This study evaluated the residual tumor rate and prognosis of breast cancer patients who underwent VABB-based resection. Methods This single-center retrospective study evaluated data of 89 Chinese female patients who underwent VABB between January 2011 and December 2018 and had confirmed malignancy on pathological diagnosis. All patients had complete clinical, treatment, and follow-up records. Outcomes were compared according to whether there was residual tumor after the VABB, as well as the time from the VABB to the surgery. Results Residual tumor was detected for 62 of the 89 patients (69.6%). When we compared the residual and non-residual groups, we detected significant differences in the ultrasonography-determined diameter (P=0.002) and morphology (P=0.000) of tumor bed after VABB. T classification was also significantly different in the residual and non-residual groups (P=0.001). However, no significant differences were observed when we compared the resected and residual tumors histopathologically (all P>0.05). We did not detect significant differences in disease-free survival (DFS) when we compared the residual and non-residual groups over a median follow-up time of 52.3 months. However, in the residual group, a longer time to surgery after VABB (>31 days) was associated with significantly shorter DFS. Conclusions While previous studies have indicated that VABB can be used for early breast cancer, we observed a residual tumor rate of 69.6%, which is consistent with previously reported results. If there is a strong suspicion of breast cancer based on the preoperative examination, the surgeon must be careful to reduce the risk of residual tumor whenever possible, and should also consider performing standard surgery after VABB.

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Underestimation of breast cancer in intraductal papillomas treated with vacuum-assisted core needle biopsy

Cited by 8 publications

References 29 publications

Breast lesions excised via vacuum-assisted system: could we get any clues for B3 lesions before excision biopsy?

Breast lesions excised via vacuum-assisted system: could we get any clues for B3 lesions before excision biopsy?

Breast lesions excised via Vacuum-Assisted System: Could We Get Any Clues for B3 Lesions Before Excision Biopsy?

Reconsidering the therapeutic use for vacuum-assisted breast biopsy in breast cancer patients: a retrospective single-center study

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