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http://dx.doi.org/10.3348/kjr.2014.15.6.697

Percutaneous Ultrasound-Guided Vacuum-Assisted Removal versus Surgery for Breast Lesions Showing Imaging-Histology Discordance after Ultrasound-Guided Core-Needle Biopsy  

Sohn, Yu-Mee (Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine)
Yoon, Jung Hyun (Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine)
Kim, Eun-Kyung (Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine)
Moon, Hee Jung (Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine)
Kim, Min Jung (Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine)
Publication Information
Korean Journal of Radiology / v.15, no.6, 2014 , pp. 697-703 More about this Journal
Abstract
Objective: To evaluate the upgrade rate and delayed false-negative results of percutaneous vacuum-assisted removal (VAR) and surgical excision in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy (CNB) of the breast and to validate the role of VAR as a rebiopsy method for these discordant lesions. Materials and Methods: Percutaneous US-guided 14-gauge CNB was performed on 7470 patients between August 2005 and December 2010. Our study population included 161 lesions in 152 patients who underwent subsequent rebiopsy due to imaging-histologic discordance. Rebiopsy was performed using VAR (n = 88) or surgical excision (n = 73). We investigated the upgrade rate immediately after rebiopsy and delayed false-negative results during at least 24 months of follow-up after rebiopsy. We also evaluated the clinicoradiological differences between VAR and surgical excision. Results: Total upgrade to malignancy occurred in 13.7% (22/161) of lesions at rebiopsy including both VAR and surgical excision: 4.6% (4/88) of VAR cases (4/88) and 24.7% (18/73) of surgical excision cases (p < 0.001). Surgical excision was performed significantly more frequently in older patients and for larger-sized lesions than that of VAR, and a significant difference was detected between VAR and surgical excision in the Breast Imaging and Reporting and Data System category (p < 0.007). No delayed false-negative results were observed after VAR or surgical excision during the follow-up period. Conclusion: Long-term follow-up data showed no delayed cancer diagnoses after US-guided VAR in imaging-histologic discordant lesions of the breast, suggesting that VAR might be a rebiopsy method for these lesions.
Keywords
Imaging-histologic discordance; Core needle biopsy; Vacuum-assisted removal; Surgical excision;
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1 Son EJ, Kim EK, Youk JH, Kim MJ, Kwak JY, Choi SH. Imaging-histologic discordance after sonographically guided percutaneous breast biopsy: a prospective observational study. Ultrasound Med Biol 2011;37:1771-1778   DOI
2 Jang M, Cho N, Moon WK, Park JS, Seong MH, Park IA. Underestimation of atypical ductal hyperplasia at sonographically guided core biopsy of the breast. AJR Am J Roentgenol 2008;191:1347-1351   DOI   ScienceOn
3 Suh YJ, Kim MJ, Kim EK, Moon HJ, Kwak JY, Koo HR, et al. Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 8- or 11-gauge vacuum-assisted biopsy. Br J Radiol 2012;85:e349-e356   DOI   ScienceOn
4 Shah VI, Raju U, Chitale D, Deshpande V, Gregory N, Strand V. False-negative core needle biopsies of the breast: an analysis of clinical, radiologic, and pathologic findings in 27 concecutive cases of missed breast cancer. Cancer 2003;97:1824-1831   DOI   ScienceOn
5 Youk JH, Kim EK, Kim MJ, Kwak JY, Son EJ. Analysis of false-negative results after US-guided 14-gauge core needle breast biopsy. Eur Radiol 2010;20:782-789   DOI
6 Kim MJ, Kim EK, Park SY, Jung HK, Park BW, Kim H, et al. Imaging-histologic discordance at sonographically guided percutaneous biopsy of breast lesions. Eur J Radiol 2008;65:163-169   DOI
7 Youk JH, Kim EK, Kim MJ, Lee JY, Oh KK. Missed breast cancers at US-guided core needle biopsy: how to reduce them. Radiographics 2007;27:79-94   DOI   ScienceOn
8 Meyer JE, Smith DN, Lester SC, DiPiro PJ, Denison CM, Harvey SC, et al. Large-needle core biopsy: nonmalignant breast abnormalities evaluated with surgical excision or repeat core biopsy. Radiology 1998;206:717-720   DOI
9 Philpotts LE, Shaheen NA, Carter D, Lange RC, Lee CH. Comparison of rebiopsy rates after stereotactic core needle biopsy of the breast with 11-gauge vacuum suction probe versus 14-gauge needle and automatic gun. AJR Am J Roentgenol 1999;172:683-687   DOI   ScienceOn
10 Liberman L, Drotman M, Morris EA, LaTrenta LR, Abramson AF, Zakowski MF, et al. Imaging-histologic discordance at percutaneous breast biopsy. Cancer 2000;89:2538-2546   DOI   ScienceOn
11 Liberman L, Feng TL, Dershaw DD, Morris EA, Abramson AF. US-guided core breast biopsy: use and cost-effectiveness. Radiology 1998;208:717-723   DOI
12 Kim MJ, Kim EK, Lee JY, Youk JH, Park BW, Kim SI, et al. Breast lesions with imaging-histologic discordance during US-guided 14G automated core biopsy: can the directional vacuum-assisted removal replace the surgical excision? Initial findings. Eur Radiol 2007;17:2376-2383   DOI   ScienceOn
13 American college of radiology. Breast imaging reporting and data system (BI-RADS) ultrasound, 4th ed. Reston, VA: American College of Radiology, 2003
14 Li JL, Wang ZL, Su L, Liu XJ, Tang J. Breast lesions with ultrasound imaging-histologic discordance at 16-gauge core needle biopsy: can re-biopsy with 10-gauge vacuum-assisted system get definitive diagnosis? Breast 2010;19:446-449   DOI
15 Mihalik JE, Krupka L, Davenport R, Tucker L, Toevs C, Smith RS. The rate of imaging-histologic discordance of benign breast disease: a multidisciplinary approach to the management of discordance at a large university-based hospital. Am J Surg 2010;199:319-323; discussion 323   DOI
16 Wang ZL, Liu G, Li JL, Su L, Liu XJ, Wang W, et al. Breast lesions with imaging-histologic discordance during 16-gauge core needle biopsy system: would vacuum-assisted removal get significantly more definitive histologic diagnosis than vacuum-assisted biopsy? Breast J 2011;17:456-461   DOI
17 Cassano E, Urban LA, Pizzamiglio M, Abbate F, Maisonneuve P, Renne G, et al. Ultrasound-guided vacuum-assisted core breast biopsy: experience with 406 cases. Breast Cancer Res Treat 2007;102:103-110   DOI
18 Rajan S, Shaaban AM, Dall BJ, Sharma N. New patient pathway using vacuum-assisted biopsy reduces diagnostic surgery for B3 lesions. Clin Radiol 2012;67:244-249   DOI
19 Dershaw DD, Morris EA, Liberman L, Abramson AF. Nondiagnostic stereotaxic core breast biopsy: results of rebiopsy. Radiology 1996;198:323-325   DOI
20 Perez-Fuentes JA, Longobardi IR, Acosta VF, Marin CE, Liberman L. Sonographically guided directional vacuum-assisted breast biopsy: preliminary experience in Venezuela. AJR Am J Roentgenol 2001;177:1459-1463   DOI   ScienceOn
21 Peter D, Grünhagen J, Wenke R, Schäfer FK, Schreer I. False-negative results after stereotactically guided vacuum biopsy. Eur Radiol 2008;18:177-182   DOI
22 Kim MJ, Park BW, Kim SI, Youk JH, Kwak JY, Moon HJ, et al. Long-term follow-up results for ultrasound-guided vacuum-assisted removal of benign palpable breast mass. Am J Surg 2010;199:1-7   DOI
23 Li S, Wu J, Chen K, Jia W, Jin L, Xiao Q, et al. Clinical outcomes of 1,578 Chinese patients with breast benign diseases after ultrasound-guided vacuum-assisted excision: recurrence and the risk factors. Am J Surg 2013;205:39-44   DOI