Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

Autor: Ayşenur Oktay, Özge Aslan, Füsun Taşkın, Nermin Tunçbilek, Selma Gül Esen İçten, Pınar Balcı, Mustafa Erkin Arıbal, Levent Çelik, İhsan Şebnem Örgüç, Figen Başaran Demirkazık, Serap Gültekin, Ayşe Murat Aydın, Emel Durmaz, Sibel Kul, Figen Binokay, Meltem Çetin, Ganime Dilek Emlik, Meltem Gülsün Akpınar, Sadiye Nuray Kadıoğlu Voyvoda, Ahmet Veysel Polat, Işıl Başara Akın, Şeyma Yıldız, Necdet Poyraz, Arzu Özsoy, Pelin Seher Öztekin, Eda Elverici, İlkay Koray Bayrak, Türkan İkizceli, Funda Dinç, Gülten Sezgin, Gökçe Gülşen, Işıl Tunçbilek, Sabiha Rabia Yalçın, Gül Çolakoğlu, Serpil Ağlamış, Ravza Yılmaz, Günay Rona, Gamze Durhan, Davut Can Güner, Fatma Çelik Yabul, Leman Günbey Karabekmez, Burçin Tutar, Muhammet Göktaş, Onur Buğdaycı, Aslı Suner, Necmettin Özdemir
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Diagnostic and Interventional Radiology, Vol 29, Iss 4, Pp 579-587 (2023)
Druh dokumentu: article
ISSN: 1305-3825
1305-3612
DOI: 10.4274/dir.2022.221790
Popis: PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision.
Databáze: Directory of Open Access Journals
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