Predictive factors for invasive cancer in surgical specimens following an initial diagnosis of ductal carcinoma in situ after stereotactic vacuum-assisted breast biopsy in microcalcification-only lesions
| Autor: | Peter Jones, Hatice Gümüş, Philippa Mills, Sue Jones, Haresh Devalia, David Fish, Metehan Gümüş, Ali Sever, Karina Cox |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Image-Guided Biopsy medicine.medical_specialty Stereotactic biopsy Breast Neoplasms Stereotaxic Techniques Breast cancer Predictive Value of Tests Biopsy Humans Medicine Mammography Neoplasm Invasiveness Radiology Nuclear Medicine and imaging skin and connective tissue diseases Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Breast Imaging Calcinosis Middle Aged medicine.disease Carcinoma Intraductal Noninfiltrating Vacuum-assisted breast biopsy Stereotaxic technique Female Radiology Microcalcification medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Diagnostic and Interventional Radiology. 22:29-34 |
| ISSN: | 1305-3612 1305-3825 |
| DOI: | 10.5152/dir.2015.14453 |
| Popis: | Because of the widespread use of breast screening mammography, the number of women diagnosed with ductal carcinoma in situ (DCIS) has increased dramatically in recent years. DCIS is a noninvasive form of breast cancer, accounting for up to 30% of breast cancers in screening populations and approximately 5% of breast carcinomas in symptomatic patients (1–3). DCIS has a variety of mammographic presentations, but the most common mammographic feature is microcalcification (4). Indeed 80%–90% of DCIS lesions present with microcalcifications only, without any accompanying mass lesions (4). Other findings such as masses, nodular abnormalities, dilated retroareolar ducts, architectural distortions, and developing densities have also been reported (5). Ultrasound-guided biopsy is often the method of choice for sonographically visible breast lesions as it provides easy access for biopsy. However, in cases when the abnormality seen on mammography is not visible on ultrasonography, stereotactic biopsy is the recommended sampling method. For microcalcification-only lesions with no accompanying mass, ultrasonography often fails to identify the site of the lesion; hence, stereotactic biopsy is used more frequently. In most breast units, stereotactic 14-gauge automated core biopsy has been replaced by stereotactic vacuum-assisted biopsy (SVAB) using 8- to 11-gauge needles (6). Large core SVAB allows larger samples to be obtained in a shorter period of time compared with samples obtained using automated core biopsy devices (7). Moreover, this technique has the advantage of a single insertion in the area of interest compared with automated core biopsy devices, which require repeated insertions. Several published articles have shown that SVAB decreased the rate of cancer underestimation and the rate of failure to retrieve breast microcalcifications (8). The management of noninvasive and invasive breast cancers is different and therefore, an accurate preoperative diagnosis is crucial for adequate surgical planning. Underestimation of DCIS lesions occurs when an invasive component is found after surgery, which had been missed at the initial preoperative sampling. The underestimation rate of stereotactic 14-gauge automated core biopsy in DCIS was reported as 16%–35% (9–11), while that of SVAB was 5%–29% (6, 9, 11–13). The purpose of this study was to determine the rate, causes, and predictive factors of underestimation of invasive carcinoma in patients diagnosed with DCIS following SVAB of microcalcification-only lesions. |
| Databáze: | OpenAIRE |
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