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Radial scar of the breast: Is it possible to avoid surgery?
Eur J Surg Oncol. 2017 Jul; 43(7):1265-1272.EJ

Abstract

INTRODUCTION

Breast radial scar (RS) management remains controversial. The need for surgical excision is supported by the concern of an associated high-grade lesion missed in the biopsy. The aim of this study was to assess histologic upgrade rate after a percutaneous biopsy, to determine if vacuum assisted biopsy prevents the need for subsequent RS surgical resection and to evaluate the upgrade risk factors.

PATIENTS AND METHODS

This was a uni-institutional retrospective study of consecutive patients with RS histologically diagnosed from January 2010 to December 2015.

RESULTS

A total of 113 cases of RS were diagnosed. We verify that there was a histologic upgrade in 22 (19.5%) cases. The upgrade risk factors were the type of biopsy performed, the presence of atypia, the presence of calcifications and the number of fragments obtained in the biopsy (p < 0.05). The biopsy type was vacuum assisted in 25 (22.1%). The upgrade rate in the vacuum assisted biopsy group was 4.0%, whereas in the standard core needle biopsy group was 23,9% (p = 0.041).

DISCUSSION AND CONCLUSION

We demonstrated that the risk of upgrade after a RS diagnosis depends on the type of biopsy performed, the presence of atypia, the presence of calcifications and the number of fragments obtained. When a standard core biopsy is performed the risk of upgrade and malignancy is not negligible, and surgery is indicated. When the biopsy is vacuum assisted, the risk of upgrade and malignancy is significantly decreased and so the indication for excisional biopsy seems not to be so imperative.

Authors+Show Affiliations

Chirurgic Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal. Electronic address: anaisabelferreira333@gmail.com.General Surgery Department, Unidade de Saúde Local de Castelo Branco, Portugal.Chirurgic Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal.Chirurgic Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal.Chirurgic Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal.Chirurgic Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal.Chirurgic Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal.Pathologic Anatomy Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal.Pathologic Anatomy Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal.Chirurgic Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal.Chirurgic Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28215506

Citation

Ferreira, A I., et al. "Radial Scar of the Breast: Is It Possible to Avoid Surgery?" European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 43, no. 7, 2017, pp. 1265-1272.
Ferreira AI, Borges S, Sousa A, et al. Radial scar of the breast: Is it possible to avoid surgery? Eur J Surg Oncol. 2017;43(7):1265-1272.
Ferreira, A. I., Borges, S., Sousa, A., Ribeiro, C., Mesquita, A., Martins, P. C., Peyroteo, M., Coimbra, N., Leal, C., Reis, P., & Sousa, J. A. (2017). Radial scar of the breast: Is it possible to avoid surgery? European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 43(7), 1265-1272. https://doi.org/10.1016/j.ejso.2017.01.238
Ferreira AI, et al. Radial Scar of the Breast: Is It Possible to Avoid Surgery. Eur J Surg Oncol. 2017;43(7):1265-1272. PubMed PMID: 28215506.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radial scar of the breast: Is it possible to avoid surgery? AU - Ferreira,A I, AU - Borges,S, AU - Sousa,A, AU - Ribeiro,C, AU - Mesquita,A, AU - Martins,P C, AU - Peyroteo,M, AU - Coimbra,N, AU - Leal,C, AU - Reis,P, AU - Sousa,J A, Y1 - 2017/02/03/ PY - 2016/11/17/received PY - 2017/01/24/revised PY - 2017/01/26/accepted PY - 2017/2/22/pubmed PY - 2017/8/19/medline PY - 2017/2/21/entrez KW - Complex sclerosing lesion KW - Histologic upgrade KW - Radial scar KW - Vacuum assisted biopsy SP - 1265 EP - 1272 JF - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology JO - Eur J Surg Oncol VL - 43 IS - 7 N2 - INTRODUCTION: Breast radial scar (RS) management remains controversial. The need for surgical excision is supported by the concern of an associated high-grade lesion missed in the biopsy. The aim of this study was to assess histologic upgrade rate after a percutaneous biopsy, to determine if vacuum assisted biopsy prevents the need for subsequent RS surgical resection and to evaluate the upgrade risk factors. PATIENTS AND METHODS: This was a uni-institutional retrospective study of consecutive patients with RS histologically diagnosed from January 2010 to December 2015. RESULTS: A total of 113 cases of RS were diagnosed. We verify that there was a histologic upgrade in 22 (19.5%) cases. The upgrade risk factors were the type of biopsy performed, the presence of atypia, the presence of calcifications and the number of fragments obtained in the biopsy (p < 0.05). The biopsy type was vacuum assisted in 25 (22.1%). The upgrade rate in the vacuum assisted biopsy group was 4.0%, whereas in the standard core needle biopsy group was 23,9% (p = 0.041). DISCUSSION AND CONCLUSION: We demonstrated that the risk of upgrade after a RS diagnosis depends on the type of biopsy performed, the presence of atypia, the presence of calcifications and the number of fragments obtained. When a standard core biopsy is performed the risk of upgrade and malignancy is not negligible, and surgery is indicated. When the biopsy is vacuum assisted, the risk of upgrade and malignancy is significantly decreased and so the indication for excisional biopsy seems not to be so imperative. SN - 1532-2157 UR - https://www.unboundmedicine.com/medline/citation/28215506/Radial_scar_of_the_breast:_Is_it_possible_to_avoid_surgery DB - PRIME DP - Unbound Medicine ER -