Breast lesions associated with mammographic architectural distortion: a study of 588 core needle biopsies.

Autor: Bachert SE; Department of Pathology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA., Jen A; Division of Breast Imaging, Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA., Denison C; Division of Breast Imaging, Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA., Kwait D; Division of Breast Imaging, Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA., Rhei E; Division of Breast Surgery, Department of Surgery, Brigham & Women's Hospital, Brigham and Women's Faulkner Hospital, and Harvard Medical School, Boston, MA, USA., Karimova J; Division of Breast Imaging, Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA., Chikarmane S; Division of Breast Imaging, Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA., Hong X; Department of Pathology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.; Department of Pathology, Brigham and Women's Faulkner Hospital and Harvard Medical School, Boston, MA, USA., Lester SC; Department of Pathology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA. slester@bwh.harvard.edu.
Jazyk: angličtina
Zdroj: Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc [Mod Pathol] 2022 Jun; Vol. 35 (6), pp. 728-738. Date of Electronic Publication: 2021 Dec 29.
DOI: 10.1038/s41379-021-00996-3
Abstrakt: Architectural distortion (AD) on mammography is a localized alteration in the uniform texture of the breast characterized by lines radiating from a central point. Radiologic/pathologic correlation is challenging because the types of lesions associated with AD are not well defined and, thus, what signifies a discordant finding requiring excision is less clear. This retrospective case series was performed to elucidate the pathologic lesions associated with AD. Over a 6-year period, 588 core needle biopsies (CNBs) were performed for AD. Thirty-eight percent of the lesions were AD alone (single feature AD) and 62% had additional imaging features (multi-feature AD). Overall, 31% showed invasive carcinoma or ductal carcinoma in situ (DCIS), 37% showed benign lesions likely to correlate with AD, and 32% showed nonspecific benign findings. The invasive carcinomas tended to be low-grade (60%), ER-positive (98%), HER2-negative (98%), and often had lobular features (52%). Ninety-two percent were AJCC pathologic stage group I. Ninety-four cases of benign findings that correlated with AD without atypia underwent excision, and only one was found to have DCIS adjacent to the sclerosing lesion (1%). The remaining cases had benign findings without a clear correlate for AD. Sixty-eight cases without atypia underwent excision, and six multi-feature AD were upgraded to invasive carcinoma (9%). In conclusion, about one-third of CNBs for lesions associated with AD reveal carcinomas that are predominantly invasive, low-grade, ER-positive, HER2-negative, and low stage. Single-feature AD differed from multi-feature AD due to a lower number of carcinomas on CNB (18% vs 39%). For CNBs showing benign lesions on biopsy with a correlate for AD, the finding of malignancy on excision is low (1%). Radiologic/pathologic correlation and decisions to recommend excision will continue to be a challenge after CNB reveals nonspecific findings as some patients with multi-feature AD were found to have undetected invasive carcinomas.
(© 2021. The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.)
Databáze: MEDLINE
Externí odkaz: