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Magnetic resonance imaging-guided core needle breast biopsies resulting in high-risk histopathologic findings: upstage frequency and lesion characteristics.
Clin Breast Cancer. 2015 Jun; 15(3):234-9.CB

Abstract

Analysis of magnetic resonance imaging-guided breast biopsies yielding high-risk histopathologic features at a single institution found an overall upstage rate to malignancy of 14% at surgical excision. All upstaged lesions were associated with atypical ductal hyperplasia. Flat epithelial atypia and atypical lobular hyperplasia alone or with lobular carcinoma in situ were not associated with an upstage to malignancy.

INTRODUCTION

The purpose of the present study w as to determine the malignancy upstage rates and imaging features of high-risk histopathologic findings resulting from magnetic resonance imaging (MRI)-guided core needle breast biopsies. These features include atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), flat epithelial atypia (FEA), and lobular carcinoma in situ (LCIS).

MATERIALS AND METHODS

A retrospective medical record review was performed on all MRI-guided core needle breast biopsies at a single institution from June 1, 2007 to December 1, 2013 to select biopsies yielding high-risk histopathologic findings. The patient demographics, MRI lesion characteristics, and histopathologic features at biopsy and surgical excision were analyzed.

RESULTS

A total of 257 MRI-guided biopsies had been performed, and 50 yielded high-risk histopathologic features (19%). Biopsy site and surgical excision site correlation was confirmed in 29 of 50 cases. Four of 29 lesions (14%) were upstaged: 1 case to invasive ductal carcinoma and 3 cases to ductal carcinoma in situ. ADH alone had an overall upstage rate of 7% (1 of 14), mixed ADH/ALH a rate of 75% (3 of 4), ALH alone or with LCIS a rate of 0% (0 of 7), and FEA a rate of 0% (0 of 4). Only mixed ADH/ALH had a statistically significant upstage rate to malignancy compared with the other high-risk histopathologic subtypes combined. No specific imaging characteristics on MRI were associated with an upstage to malignancy on the statistical analysis.

CONCLUSION

MRI-guided breast biopsies yielding high-risk histopathologic features were associated with an overall upstage to malignancy rate of 14% at surgical excision. All upstaged lesions were associated with ADH. FEA and ALH alone or with LCIS were not associated with an upstage to malignancy.

Authors+Show Affiliations

Department of Diagnostic Imaging, Moffitt Cancer Center, Tampa, FL. Electronic address: robert.weinfurtner@moffitt.org.Department of Diagnostic Imaging, Moffitt Cancer Center, Tampa, FL.Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL.Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL.Department of Diagnostic Imaging, Moffitt Cancer Center, Tampa, FL.Department of Diagnostic Imaging, Moffitt Cancer Center, Tampa, FL.Department of Biostatistics, Moffitt Cancer Center, Tampa, FL.Department of Diagnostic Imaging, Moffitt Cancer Center, Tampa, FL.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25579460

Citation

Weinfurtner, R Jared, et al. "Magnetic Resonance Imaging-guided Core Needle Breast Biopsies Resulting in High-risk Histopathologic Findings: Upstage Frequency and Lesion Characteristics." Clinical Breast Cancer, vol. 15, no. 3, 2015, pp. 234-9.
Weinfurtner RJ, Patel B, Laronga C, et al. Magnetic resonance imaging-guided core needle breast biopsies resulting in high-risk histopathologic findings: upstage frequency and lesion characteristics. Clin Breast Cancer. 2015;15(3):234-9.
Weinfurtner, R. J., Patel, B., Laronga, C., Lee, M. C., Falcon, S. L., Mooney, B. P., Yue, B., & Drukteinis, J. S. (2015). Magnetic resonance imaging-guided core needle breast biopsies resulting in high-risk histopathologic findings: upstage frequency and lesion characteristics. Clinical Breast Cancer, 15(3), 234-9. https://doi.org/10.1016/j.clbc.2014.12.005
Weinfurtner RJ, et al. Magnetic Resonance Imaging-guided Core Needle Breast Biopsies Resulting in High-risk Histopathologic Findings: Upstage Frequency and Lesion Characteristics. Clin Breast Cancer. 2015;15(3):234-9. PubMed PMID: 25579460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnetic resonance imaging-guided core needle breast biopsies resulting in high-risk histopathologic findings: upstage frequency and lesion characteristics. AU - Weinfurtner,R Jared, AU - Patel,Bhavika, AU - Laronga,Christine, AU - Lee,Marie C, AU - Falcon,Shannon L, AU - Mooney,Blaise P, AU - Yue,Binglin, AU - Drukteinis,Jennifer S, Y1 - 2014/12/24/ PY - 2014/10/28/received PY - 2014/12/05/revised PY - 2014/12/16/accepted PY - 2015/1/13/entrez PY - 2015/1/13/pubmed PY - 2016/1/16/medline KW - Atypia KW - Atypical ductal hyperplasia KW - Atypical lobular hyperplasia KW - Flat epithelial atypia KW - Lobular carcinoma in situ KW - MRI-guided breast biopsy SP - 234 EP - 9 JF - Clinical breast cancer JO - Clin. Breast Cancer VL - 15 IS - 3 N2 - UNLABELLED: Analysis of magnetic resonance imaging-guided breast biopsies yielding high-risk histopathologic features at a single institution found an overall upstage rate to malignancy of 14% at surgical excision. All upstaged lesions were associated with atypical ductal hyperplasia. Flat epithelial atypia and atypical lobular hyperplasia alone or with lobular carcinoma in situ were not associated with an upstage to malignancy. INTRODUCTION: The purpose of the present study w as to determine the malignancy upstage rates and imaging features of high-risk histopathologic findings resulting from magnetic resonance imaging (MRI)-guided core needle breast biopsies. These features include atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), flat epithelial atypia (FEA), and lobular carcinoma in situ (LCIS). MATERIALS AND METHODS: A retrospective medical record review was performed on all MRI-guided core needle breast biopsies at a single institution from June 1, 2007 to December 1, 2013 to select biopsies yielding high-risk histopathologic findings. The patient demographics, MRI lesion characteristics, and histopathologic features at biopsy and surgical excision were analyzed. RESULTS: A total of 257 MRI-guided biopsies had been performed, and 50 yielded high-risk histopathologic features (19%). Biopsy site and surgical excision site correlation was confirmed in 29 of 50 cases. Four of 29 lesions (14%) were upstaged: 1 case to invasive ductal carcinoma and 3 cases to ductal carcinoma in situ. ADH alone had an overall upstage rate of 7% (1 of 14), mixed ADH/ALH a rate of 75% (3 of 4), ALH alone or with LCIS a rate of 0% (0 of 7), and FEA a rate of 0% (0 of 4). Only mixed ADH/ALH had a statistically significant upstage rate to malignancy compared with the other high-risk histopathologic subtypes combined. No specific imaging characteristics on MRI were associated with an upstage to malignancy on the statistical analysis. CONCLUSION: MRI-guided breast biopsies yielding high-risk histopathologic features were associated with an overall upstage to malignancy rate of 14% at surgical excision. All upstaged lesions were associated with ADH. FEA and ALH alone or with LCIS were not associated with an upstage to malignancy. SN - 1938-0666 UR - https://www.unboundmedicine.com/medline/citation/25579460/Magnetic_resonance_imaging_guided_core_needle_breast_biopsies_resulting_in_high_risk_histopathologic_findings:_upstage_frequency_and_lesion_characteristics_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1526-8209(14)00286-9 DB - PRIME DP - Unbound Medicine ER -