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Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary?
Cancer. 2003 Jan 15; 97(2):345-51.C

Abstract

BACKGROUND

Radial scars are benign lesions that may mimic breast carcinoma on mammography and usually are managed by excision biopsy. The authors report their experience with stereotactic needle core biopsy (SNCB) in sampling these lesions.

METHODS

A prospective study examined a consecutive series of 75 mammographically detected radial scars from a population-based screening program. In patients who were sampled by SNCB followed by surgical biopsy, the histologic findings of core biopsy and the gold standard of excision biopsy were compared.

RESULTS

Sixty-three patients were sampled by core biopsy: SNCB was used in 55 patients (87.0%), and ultrasound-guided needle core biopsy (UNCB) was used in 8 patients (13%). One patient who underwent SNCB did not undergo a follow-up excision biopsy. Radial scars were diagnosed preoperatively by core biopsy in 51 of 62 patients who underwent excision (82%; 95% confidence interval [95%CI], 70-91%). The sensitivity for SNCB was 85% (95%CI, 73-94%), and the sensitivity for UNCB was 63% (95%CI, 24-91%). Of 54 patients who underwent SNCB and excision, 4 patients had coexistent ductal carcinoma in situ (DCIS) at the time they underwent surgical excision: SNCB identified DCIS in 1 patient and identified atypical ductal hyperplasia (ADH) in 3 patients. In the entire group of 75 radial scars, 5 scars were associated with DCIS (7%), and there were no invasive carcinomas. ADH was present in association with 42 of 74 radial scars that were excised surgically (57%). Twenty-nine of those radial scars were sampled preoperatively by SNCB. ADH was found in 21 patients (72%; 95CI, 53-87%).

CONCLUSIONS

The sensitivity of SNCB in the identification of radial scars was 85%. In four patients with associated DCIS, SNCB revealed either ADH or DCIS, both of which required excision. These findings suggest that patients with SNCB-proven radial scars among a screened population can be managed safely by mammographic follow-up, provided there is no associated DCIS, ADH, or lobular carcinoma in situ. Spiculated abnormalities with discordant SNCB results require surgical biopsy.

Authors+Show Affiliations

Breast Screen Department, St Vincent's Hospital, University of Melbourne, Fitzroy, Victoria, Australia. cawsonjn@svhm.org.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

12518358

Citation

Cawson, Jennifer N., et al. "Fourteen-gauge Needle Core Biopsy of Mammographically Evident Radial Scars: Is Excision Necessary?" Cancer, vol. 97, no. 2, 2003, pp. 345-51.
Cawson JN, Malara F, Kavanagh A, et al. Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary? Cancer. 2003;97(2):345-51.
Cawson, J. N., Malara, F., Kavanagh, A., Hill, P., Balasubramanium, G., & Henderson, M. (2003). Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary? Cancer, 97(2), 345-51.
Cawson JN, et al. Fourteen-gauge Needle Core Biopsy of Mammographically Evident Radial Scars: Is Excision Necessary. Cancer. 2003 Jan 15;97(2):345-51. PubMed PMID: 12518358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary? AU - Cawson,Jennifer N, AU - Malara,Frank, AU - Kavanagh,Anne, AU - Hill,Prue, AU - Balasubramanium,Gnani, AU - Henderson,Michael, PY - 2003/1/9/pubmed PY - 2003/4/1/medline PY - 2003/1/9/entrez SP - 345 EP - 51 JF - Cancer JO - Cancer VL - 97 IS - 2 N2 - BACKGROUND: Radial scars are benign lesions that may mimic breast carcinoma on mammography and usually are managed by excision biopsy. The authors report their experience with stereotactic needle core biopsy (SNCB) in sampling these lesions. METHODS: A prospective study examined a consecutive series of 75 mammographically detected radial scars from a population-based screening program. In patients who were sampled by SNCB followed by surgical biopsy, the histologic findings of core biopsy and the gold standard of excision biopsy were compared. RESULTS: Sixty-three patients were sampled by core biopsy: SNCB was used in 55 patients (87.0%), and ultrasound-guided needle core biopsy (UNCB) was used in 8 patients (13%). One patient who underwent SNCB did not undergo a follow-up excision biopsy. Radial scars were diagnosed preoperatively by core biopsy in 51 of 62 patients who underwent excision (82%; 95% confidence interval [95%CI], 70-91%). The sensitivity for SNCB was 85% (95%CI, 73-94%), and the sensitivity for UNCB was 63% (95%CI, 24-91%). Of 54 patients who underwent SNCB and excision, 4 patients had coexistent ductal carcinoma in situ (DCIS) at the time they underwent surgical excision: SNCB identified DCIS in 1 patient and identified atypical ductal hyperplasia (ADH) in 3 patients. In the entire group of 75 radial scars, 5 scars were associated with DCIS (7%), and there were no invasive carcinomas. ADH was present in association with 42 of 74 radial scars that were excised surgically (57%). Twenty-nine of those radial scars were sampled preoperatively by SNCB. ADH was found in 21 patients (72%; 95CI, 53-87%). CONCLUSIONS: The sensitivity of SNCB in the identification of radial scars was 85%. In four patients with associated DCIS, SNCB revealed either ADH or DCIS, both of which required excision. These findings suggest that patients with SNCB-proven radial scars among a screened population can be managed safely by mammographic follow-up, provided there is no associated DCIS, ADH, or lobular carcinoma in situ. Spiculated abnormalities with discordant SNCB results require surgical biopsy. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/12518358/Fourteen_gauge_needle_core_biopsy_of_mammographically_evident_radial_scars:_is_excision_necessary L2 - https://doi.org/10.1002/cncr.11070 DB - PRIME DP - Unbound Medicine ER -