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Correlation between core biopsy and excisional biopsy in breast high-risk lesions.
Am J Surg. 2006 Oct; 192(4):534-7.AJ

Abstract

BACKGROUND

The purpose of the current study was to compare the prevalence of invasive or in situ cancer at excisional biopsy in patients with image-guided core needle biopsy (CNB)-proven atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), or lobular carcinoma-in-situ (LCIS). Factors affecting the upgrade rate to malignancy were also identified.

METHODS

Patients diagnosed with ADH, ALH, or LCIS on image-guided CNB (stereotactic or ultrasound) from 1995 to 2005 were identified through radiologic and surgical databases. Patients who subsequently underwent excisional biopsy of their lesion were included in the study. The imaging, medical records, and pathology of these patients were reviewed.

RESULTS

Ninety-six patients with either ADH (61/96, 63%), ALH (19/96, 20%), or LCIS (16/96, 17%) on image-guided CNB proceeded to excisional biopsy. Malignancy was detected on excisional biopsy in 31% of patients with ADH, 16% of patients with ALH, and 25% of patients with LCIS. There were no significant differences between the 2 groups in terms of age, parity, hormonal status, or previous benign breast biopsies. The presence of a mass on mammography was associated with an increased upgrade rate to malignancy, while biopsies performed using vacuum-assisted devices, larger gauge biopsy needles, and greater number of cores were associated with a lower upgrade rate.

CONCLUSIONS

Our data suggest that excisional biopsy is warranted in all patients with CNB diagnoses of ADH, ALH, or LCIS to exclude the presence of cancer.

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Authors+Show Affiliations

Margenthaler JA
Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. margenthalerj@wudosis.wustl.edu
Duke D
No affiliation info available
Monsees BS
No affiliation info available
Barton PT
No affiliation info available
Clark C
No affiliation info available
Dietz JR
No affiliation info available

MeSH

AdultAgedAged, 80 and overBiopsy, NeedleBreast NeoplasmsCarcinoma in SituCarcinoma, Intraductal, NoninfiltratingFemaleHumansHyperplasiaMammary Glands, HumanMastectomy, SegmentalMiddle AgedPrevalenceRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16978969

Citation

Margenthaler, Julie A., et al. "Correlation Between Core Biopsy and Excisional Biopsy in Breast High-risk Lesions." American Journal of Surgery, vol. 192, no. 4, 2006, pp. 534-7.
Margenthaler JA, Duke D, Monsees BS, et al. Correlation between core biopsy and excisional biopsy in breast high-risk lesions. Am J Surg. 2006;192(4):534-7.
Margenthaler, J. A., Duke, D., Monsees, B. S., Barton, P. T., Clark, C., & Dietz, J. R. (2006). Correlation between core biopsy and excisional biopsy in breast high-risk lesions. American Journal of Surgery, 192(4), 534-7.
Margenthaler JA, et al. Correlation Between Core Biopsy and Excisional Biopsy in Breast High-risk Lesions. Am J Surg. 2006;192(4):534-7. PubMed PMID: 16978969.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation between core biopsy and excisional biopsy in breast high-risk lesions. AU - Margenthaler,Julie A, AU - Duke,Deirdre, AU - Monsees,Barbara S, AU - Barton,Premsri T, AU - Clark,Chrystia, AU - Dietz,Jill R, PY - 2006/03/24/received PY - 2006/06/06/revised PY - 2006/06/06/accepted PY - 2006/9/19/pubmed PY - 2006/11/7/medline PY - 2006/9/19/entrez SP - 534 EP - 7 JF - American journal of surgery JO - Am J Surg VL - 192 IS - 4 N2 - BACKGROUND: The purpose of the current study was to compare the prevalence of invasive or in situ cancer at excisional biopsy in patients with image-guided core needle biopsy (CNB)-proven atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), or lobular carcinoma-in-situ (LCIS). Factors affecting the upgrade rate to malignancy were also identified. METHODS: Patients diagnosed with ADH, ALH, or LCIS on image-guided CNB (stereotactic or ultrasound) from 1995 to 2005 were identified through radiologic and surgical databases. Patients who subsequently underwent excisional biopsy of their lesion were included in the study. The imaging, medical records, and pathology of these patients were reviewed. RESULTS: Ninety-six patients with either ADH (61/96, 63%), ALH (19/96, 20%), or LCIS (16/96, 17%) on image-guided CNB proceeded to excisional biopsy. Malignancy was detected on excisional biopsy in 31% of patients with ADH, 16% of patients with ALH, and 25% of patients with LCIS. There were no significant differences between the 2 groups in terms of age, parity, hormonal status, or previous benign breast biopsies. The presence of a mass on mammography was associated with an increased upgrade rate to malignancy, while biopsies performed using vacuum-assisted devices, larger gauge biopsy needles, and greater number of cores were associated with a lower upgrade rate. CONCLUSIONS: Our data suggest that excisional biopsy is warranted in all patients with CNB diagnoses of ADH, ALH, or LCIS to exclude the presence of cancer. SN - 0002-9610 UR - https://www.unboundmedicine.com/medline/citation/16978969/Correlation_between_core_biopsy_and_excisional_biopsy_in_breast_high_risk_lesions_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(06)00451-X DB - PRIME DP - Unbound Medicine ER -