Literature DB >> 25579460

Magnetic resonance imaging-guided core needle breast biopsies resulting in high-risk histopathologic findings: upstage frequency and lesion characteristics.

R Jared Weinfurtner1, Bhavika Patel2, Christine Laronga3, Marie C Lee3, Shannon L Falcon2, Blaise P Mooney2, Binglin Yue4, Jennifer S Drukteinis2.   

Abstract

UNLABELLED: Analysis of magnetic resonance imaging-guided breast biopsies yielding high-risk histopathologic features at a single institution found an overall upstage rate to malignancy of 14% at surgical excision. All upstaged lesions were associated with atypical ductal hyperplasia. Flat epithelial atypia and atypical lobular hyperplasia alone or with lobular carcinoma in situ were not associated with an upstage to malignancy.
INTRODUCTION: The purpose of the present study w as to determine the malignancy upstage rates and imaging features of high-risk histopathologic findings resulting from magnetic resonance imaging (MRI)-guided core needle breast biopsies. These features include atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), flat epithelial atypia (FEA), and lobular carcinoma in situ (LCIS).
MATERIALS AND METHODS: A retrospective medical record review was performed on all MRI-guided core needle breast biopsies at a single institution from June 1, 2007 to December 1, 2013 to select biopsies yielding high-risk histopathologic findings. The patient demographics, MRI lesion characteristics, and histopathologic features at biopsy and surgical excision were analyzed.
RESULTS: A total of 257 MRI-guided biopsies had been performed, and 50 yielded high-risk histopathologic features (19%). Biopsy site and surgical excision site correlation was confirmed in 29 of 50 cases. Four of 29 lesions (14%) were upstaged: 1 case to invasive ductal carcinoma and 3 cases to ductal carcinoma in situ. ADH alone had an overall upstage rate of 7% (1 of 14), mixed ADH/ALH a rate of 75% (3 of 4), ALH alone or with LCIS a rate of 0% (0 of 7), and FEA a rate of 0% (0 of 4). Only mixed ADH/ALH had a statistically significant upstage rate to malignancy compared with the other high-risk histopathologic subtypes combined. No specific imaging characteristics on MRI were associated with an upstage to malignancy on the statistical analysis.
CONCLUSION: MRI-guided breast biopsies yielding high-risk histopathologic features were associated with an overall upstage to malignancy rate of 14% at surgical excision. All upstaged lesions were associated with ADH. FEA and ALH alone or with LCIS were not associated with an upstage to malignancy.
Copyright © 2015 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Atypia; Atypical ductal hyperplasia; Atypical lobular hyperplasia; Flat epithelial atypia; Lobular carcinoma in situ; MRI-guided breast biopsy

Mesh:

Year:  2014        PMID: 25579460     DOI: 10.1016/j.clbc.2014.12.005

Source DB:  PubMed          Journal:  Clin Breast Cancer        ISSN: 1526-8209            Impact factor:   3.225


  5 in total

Review 1.  Paradigm Shifts in Breast Care Delivery: Impact of Imaging in a Multidisciplinary Environment.

Authors:  Savitri Krishnamurthy; Therese Bevers; Henry M Kuerer; Benjamin Smith; Wei Tse Yang
Journal:  AJR Am J Roentgenol       Date:  2016-12-08       Impact factor: 3.959

2.  High-risk lesions in the breast diagnosed by MRI-guided core biopsy: upgrade rates and features associated with malignancy.

Authors:  Eumee Cha; Emily B Ambinder; Eniola T Oluyemi; Lisa A Mullen; Babita Panigrahi; Joanna Rossi; Philip A Di Carlo; Kelly S Myers
Journal:  Breast Cancer Res Treat       Date:  2022-10-15       Impact factor: 4.624

3.  Gene Methylation and Cytological Atypia in Random Fine-Needle Aspirates for Assessment of Breast Cancer Risk.

Authors:  Vered Stearns; Mary Jo Fackler; Seema A Khan; Saraswati Sukumar; Sidra Hafeez; Zoila Lopez Bujanda; Robert T Chatterton; Lisa K Jacobs; Nagi F Khouri; David Ivancic; Kara Kenney; Christina Shehata; Stacie C Jeter; Judith A Wolfman; Carola M Zalles; Peng Huang
Journal:  Cancer Prev Res (Phila)       Date:  2016-06-03

4.  Diagnostic value of radiomics and machine learning with dynamic contrast-enhanced magnetic resonance imaging for patients with atypical ductal hyperplasia in predicting malignant upgrade.

Authors:  Roberto Lo Gullo; Kerri Vincenti; Carolina Rossi Saccarelli; Peter Gibbs; Michael J Fox; Isaac Daimiel; Danny F Martinez; Maxine S Jochelson; Elizabeth A Morris; Jeffrey S Reiner; Katja Pinker
Journal:  Breast Cancer Res Treat       Date:  2021-01-20       Impact factor: 4.872

5.  The effect of delay of excisional biopsy on upstage rate for atypical ductal hyperplasia, flat epithelial atypia, intraductal papilloma, and radial scar.

Authors:  Jesse Casaubon; Shiva Niakan; Emily Vicks; Aixa Perez Coulter; Danielle L Jacobbe; Holly Mason
Journal:  Breast Cancer Res Treat       Date:  2022-10-01       Impact factor: 4.624

  5 in total

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