Underestimation of Breast Cancer with II-Gauge Vacuum Suction  Biopsy

Philpotts, Liane E.; Lee, Carol H.; Horváth, L.; Lange, Robert; Carter, Darryl; Tocino, Irena

doi:10.2214/ajr.175.4.1751047

Cited by 122 publications

(74 citation statements)

References 18 publications

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“…So underestimation rate using US-guided CNB could be not related with clinical condition. Some reports show that almost underestimated breast cancers (93%) with vacuum suction biopsy were reported as calcifications on mammogram (Philpotts et al, 2000). Our study suggest that the underestimation rate for calcifications were 9.4% (7/74) on mammogram and 12.5% (5/40) on US imaging, although we could not have targeted calcification only lesion on US imaging.…”

Section: Resultscontrasting

confidence: 55%

US-guided 14G Core Needle Biopsy: Comparison Between Underestimated and Correctly Diagnosed Breast Cancers

Kim

Youk²,

Kim³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoing ultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated and accurately diagnosed groups. Materials and Methods: Of 1,898 cases of US-guided 14G CNB in our institute, 233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductal carcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in 14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11 cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctly diagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breast cancers were compared. Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Among underestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB proven ADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results were IDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADS category, margin of mass on mammography and US and orientation of lesion on US revealed statistically significant differences. Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Between underestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography and margin and orientation of the lesions on US were different.

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Section: Resultscontrasting

confidence: 55%

US-guided 14G Core Needle Biopsy: Comparison Between Underestimated and Correctly Diagnosed Breast Cancers

Kim

Youk²,

Kim³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Technical advances in percutaneous core needle biopsy, such as increasing needle diameter from 14-gauge to 11-gauge and adding a vacuum device, have allowed larger samples of tissue to be obtained (5,6), substantially improving the accuracy of diagnosis. Despite these improvements, the rate of underestimation for ADH has been reported as 10% to 26% for 11-gauge vacuum-assisted biopsy (VAB) (2,14,(21)(22)(23)(24)(25)(26)(27)(28). In this study, 11-gauge SVAB was associated with a lower rate of underestimation for ADH (20.6%), compared to USguided 14-gauge automated biopsy (41.7%) (P = 0.007).…”

Section: Discussionmentioning

confidence: 84%

“…They also found that the risk of underestimation did not increase with the maximum size of the lesion for ADH, with SVAB (24,25). Decreased underestimation rates with SVAB were found to be statistically significant if the maximum diameter of the lesion was less than 10 mm (2).…”

Section: Discussionmentioning

confidence: 93%

“…Although Jackman et al (2) reported higher underestimation rates for VAB of mass lesions than of microcalcifications, Philpotts et al (24) found a significantly higher underestimation rate for VAB of microcalcifications than of masses. Jang et al (20) found no difference in terms of the lesion type between the two groups with US-guided core needle biopsy.…”

Section: Discussionmentioning

confidence: 97%

“…Some investigators reported no association between the number of core specimens obtained for groups that were underestimated with both 14-gauge core needle biopsy (19) and VAB (2,24,25). Jackman et al (16) reported that the underestimation of malignant disease increased with VAB when the number of cores obtained per lesion was 10 or less.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Factors that impact the upgrading of atypical ductal hyperplasia

Gümüş

Mills²,

Gümüş³

et al. 2012

Diagn Interv Radiol

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Upstaging of Atypical Ductal Hyperplasia After Vacuum-Assisted 11-Gauge Stereotactic Core Needle Biopsy

Winchester¹

2003

Arch Surg

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Background: Nonpalpable mammographic abnormalities are frequently evaluated by means of a stereotactic core needle biopsy. This technique is a very sensitive indicator of invasive cancer, but is less reliable to discriminate between ductal carcinoma in situ and atypical ductal hyperplasia (ADH). The objective of this study was to determine the correlation of the 11-gauge vacuumassisted core needle biopsy to open biopsy when a diagnosis of ADH is obtained. Hypothesis: The use of 11-gauge vacuum-assisted stereotactic core needle biopsy does not conclusively diagnose ADH. Design: Retrospective analysis. Setting: University-affiliated teaching hospital. Patients: Mammographic findings were evaluated with an 11-gauge vacuum-assisted stereotactic core biopsy in 1750 patients. Seventy-seven patients were diagnosed as having ADH; of these, 65 underwent excisional biopsy. Main Outcome Measures: Pathological upstaging rate. Results: Of the 65 patients who underwent excisional breast biopsy, 11 (17%) had their condition upstaged to a breast cancer diagnosis. These patients had presented at a later age than those who retained a benign diagnosis after excisional biopsy. The number of cores taken did not correlate with diagnostic accuracy. Conclusions: Of the 65 patients who underwent open biopsy for ADH in this series, only 83% had an accurate diagnosis. A diagnosis of ADH by stereotactic core needle biopsy should be followed by an open excisional biopsy.

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Underestimation of Breast Cancer with II-Gauge Vacuum Suction Biopsy

Cited by 122 publications

References 18 publications

US-guided 14G Core Needle Biopsy: Comparison Between Underestimated and Correctly Diagnosed Breast Cancers

US-guided 14G Core Needle Biopsy: Comparison Between Underestimated and Correctly Diagnosed Breast Cancers

Factors that impact the upgrading of atypical ductal hyperplasia

Upstaging of Atypical Ductal Hyperplasia After Vacuum-Assisted 11-Gauge Stereotactic Core Needle Biopsy

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