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Radial Scar at Percutaneous Breast Biopsy That Does Not Require Surgery.
J Am Coll Surg. 2016 11; 223(5):712-716.JA

Abstract

BACKGROUND

Surgical excision is currently recommended after pathologic radial scar is found on breast core needle biopsy because surgical upgrade to carcinoma is not uncommon. The goal of our study was to identify the true pathologic upgrade rate for a "pure" radial scar, those without associated proliferative lesion, based on indication for biopsy, biopsy type, and needle size.

STUDY DESIGN

The pathology database of Continuum Health Partners was searched for the terms radial scar and radial sclerosing lesion, from January 2007 to December 2015. From review of 1,513 pathology reports, 292 cases of core biopsies without malignancy were identified. Age, indication for biopsy, type of biopsy, and excisional pathology were obtained. Data were then analyzed using SPSS.

RESULTS

Two hundred nineteen (75%) of the 292 core biopsies showed pure radial scar without associated proliferative lesion, and 161 (74%) of these patients had surgical excision. Only 1 of these patients had disease that was upgraded to ductal carcinoma in situ-a 2-mm focus located 5 mm away from the radial scar biopsy cavity. This patient also had residual calcifications on mammography after the stereotactic biopsy. Six additional malignant upgrades were found in patients who had radial scar associated with atypical ductal hyperplasia (n = 5) or lobular neoplasia (n = 1) on needle biopsy.

CONCLUSIONS

Surgical excision is unnecessary when radial scar is found at percutaneous needle biopsy without an associated proliferative lesion. Surgical excision is still indicated when radial scar is associated with atypical ductal hyperplasia or lobular neoplasia.

Authors+Show Affiliations

Department of Breast Surgery, Mount Sinai West, New York, NY.Department of Breast Surgery, Monmouth Medical Center, Long Branch, NJ.Department of Pathology, Mount Sinai West, New York, NY.Department of Breast Surgery, Mount Sinai West, New York, NY.Department of Breast Surgery, Mount Sinai West, New York, NY. Electronic address: ptartter@chpnet.org.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27542917

Citation

Leong, Rachelle Y., et al. "Radial Scar at Percutaneous Breast Biopsy That Does Not Require Surgery." Journal of the American College of Surgeons, vol. 223, no. 5, 2016, pp. 712-716.
Leong RY, Kohli MK, Zeizafoun N, et al. Radial Scar at Percutaneous Breast Biopsy That Does Not Require Surgery. J Am Coll Surg. 2016;223(5):712-716.
Leong, R. Y., Kohli, M. K., Zeizafoun, N., Liang, A., & Tartter, P. I. (2016). Radial Scar at Percutaneous Breast Biopsy That Does Not Require Surgery. Journal of the American College of Surgeons, 223(5), 712-716. https://doi.org/10.1016/j.jamcollsurg.2016.08.003
Leong RY, et al. Radial Scar at Percutaneous Breast Biopsy That Does Not Require Surgery. J Am Coll Surg. 2016;223(5):712-716. PubMed PMID: 27542917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radial Scar at Percutaneous Breast Biopsy That Does Not Require Surgery. AU - Leong,Rachelle Y, AU - Kohli,Manpreet K, AU - Zeizafoun,Nebraz, AU - Liang,Amy, AU - Tartter,Paul I, Y1 - 2016/08/16/ PY - 2016/06/16/received PY - 2016/07/27/revised PY - 2016/08/02/accepted PY - 2016/10/30/pubmed PY - 2017/8/8/medline PY - 2016/8/21/entrez SP - 712 EP - 716 JF - Journal of the American College of Surgeons JO - J Am Coll Surg VL - 223 IS - 5 N2 - BACKGROUND: Surgical excision is currently recommended after pathologic radial scar is found on breast core needle biopsy because surgical upgrade to carcinoma is not uncommon. The goal of our study was to identify the true pathologic upgrade rate for a "pure" radial scar, those without associated proliferative lesion, based on indication for biopsy, biopsy type, and needle size. STUDY DESIGN: The pathology database of Continuum Health Partners was searched for the terms radial scar and radial sclerosing lesion, from January 2007 to December 2015. From review of 1,513 pathology reports, 292 cases of core biopsies without malignancy were identified. Age, indication for biopsy, type of biopsy, and excisional pathology were obtained. Data were then analyzed using SPSS. RESULTS: Two hundred nineteen (75%) of the 292 core biopsies showed pure radial scar without associated proliferative lesion, and 161 (74%) of these patients had surgical excision. Only 1 of these patients had disease that was upgraded to ductal carcinoma in situ-a 2-mm focus located 5 mm away from the radial scar biopsy cavity. This patient also had residual calcifications on mammography after the stereotactic biopsy. Six additional malignant upgrades were found in patients who had radial scar associated with atypical ductal hyperplasia (n = 5) or lobular neoplasia (n = 1) on needle biopsy. CONCLUSIONS: Surgical excision is unnecessary when radial scar is found at percutaneous needle biopsy without an associated proliferative lesion. Surgical excision is still indicated when radial scar is associated with atypical ductal hyperplasia or lobular neoplasia. SN - 1879-1190 UR - https://www.unboundmedicine.com/medline/citation/27542917/Radial_Scar_at_Percutaneous_Breast_Biopsy_That_Does_Not_Require_Surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1072-7515(16)30724-4 DB - PRIME DP - Unbound Medicine ER -