Imaging Follow-up Versus Surgical Excision for Radial Scars Identified on Tomosynthesis-Guided Core Needle Biopsy
| Autor: | Kenneth R. Hess, Davis C. Teichgraeber, Toma S. Omofoye, Sarah Martaindale, Gary J. Whitman |
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| Rok vydání: | 2020 |
| Předmět: |
Core needle
medicine.medical_specialty Digital mammography Radial scar Scars Breast Neoplasms Malignancy 030218 nuclear medicine & medical imaging Cicatrix 03 medical and health sciences 0302 clinical medicine Biopsy medicine Atypia Humans Radiology Nuclear Medicine and imaging skin and connective tissue diseases Retrospective Studies medicine.diagnostic_test business.industry medicine.disease Tomosynthesis body regions 030220 oncology & carcinogenesis Biopsy Large-Core Needle Radiology medicine.symptom business Follow-Up Studies Mammography |
| Zdroj: | Academic Radiology. 27:389-394 |
| ISSN: | 1076-6332 |
| DOI: | 10.1016/j.acra.2019.05.012 |
| Popis: | Rationale and Objectives We investigated if imaging or pathology features could determine when imaging follow-up is appropriate after diagnosis of radial scar on digital breast tomosynthesis (DBT)-guided core needle biopsy (CNB). Materials and Methods We conducted a retrospective review of all patients diagnosed with radial scars on DBT-guided CNB at our institution between November 2014 and December 2016. Cases were excluded if DCIS or invasive malignancy was present in the same core specimens. Patient age; needle size; number of cores; visibility on full-field digital mammography versus DBT; lesion size; presence of architectural distortion, mass, or calcifications; imaging stability; presence or absence of atypia; length of imaging follow-up, and excisional pathology were collected. Results Of 45 eligible biopsies, 6 cases had radial scars with associated atypia and 39 cases had no associated atypia. Twenty-four patients underwent surgical excision, including all patients with atypia on CNB. One case (4%) was upstaged to DCIS on surgical excision after CNB revealed a radial scar with associated ADH. There was also a case without atypia on CNB, but excisional pathology revealed associated ADH. In cases with radial scars and associated atypia on CNB, the upstage rate was 17%. In cases without atypia on CNB that underwent surgical excision, the upstage rate was 0%. Imaging follow-up was available in 13 patients who did not undergo surgical excision, with stability in all 13 with a median follow-up of 18 months. Conclusion Annual imaging follow-up appears reasonable in selected patients with radial scars but no atypia on DBT-guided CNB. |
| Databáze: | OpenAIRE |
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