Gustavo Machado Badan1, Decio Roveda Júnior2, Sebastião Piato3, Eduardo de Faria Castro Fleury4, Mário Sérgio Dantas Campos5, Carlos Alberto Ferreira Pecci5, Felipe Augusto Trocoli Ferreira5, Camila D'Ávila6. 1. PhD Fellow, Physician Assistant II at Unit of Imaging Diagnosis, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil. 2. PhD, Coordinator for the Sector of Breast Imaging, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil. 3. PhD, Full Professor at School of Medical Sciences, Santa Casa de São Paulo, Chief of Medical Practice at Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil. 4. PhD, Physician Assistant II at Unit of Imaging Diagnosis, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil. 5. Imaging Diagnosis Specialists, Physician Assistants II at Unit of Imaging Diagnosis, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil. 6. Imaging Diagnosis Specialist, MD, Resident in General Radiology, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
Abstract
OBJECTIVE: To determine the rates of diagnostic underestimation at stereotactic percutaneous core needle biopsies (CNB) and vacuum-assisted biopsies (VABB) of nonpalpable breast lesions, with histopathological results of atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS) subsequently submitted to surgical excision. As a secondary objective, the frequency of ADH and DCIS was determined for the cases submitted to biopsy. MATERIALS AND METHODS: Retrospective review of 40 cases with diagnosis of ADH or DCIS on the basis of biopsies performed between February 2011 and July 2013, subsequently submitted to surgery, whose histopathological reports were available in the internal information system. Biopsy results were compared with those observed at surgery and the underestimation rate was calculated by means of specific mathematical equations. RESULTS: The underestimation rate at CNB was 50% for ADH and 28.57% for DCIS, and at VABB it was 25% for ADH and 14.28% for DCIS. ADH represented 10.25% of all cases undergoing biopsy, whereas DCIS accounted for 23.91%. CONCLUSION: The diagnostic underestimation rate at CNB is two times the rate at VABB. Certainty that the target has been achieved is not the sole determining factor for a reliable diagnosis. Removal of more than 50% of the target lesion should further reduce the risk of underestimation.
OBJECTIVE: To determine the rates of diagnostic underestimation at stereotactic percutaneous core needle biopsies (CNB) and vacuum-assisted biopsies (VABB) of nonpalpable breast lesions, with histopathological results of atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS) subsequently submitted to surgical excision. As a secondary objective, the frequency of ADH and DCIS was determined for the cases submitted to biopsy. MATERIALS AND METHODS: Retrospective review of 40 cases with diagnosis of ADH or DCIS on the basis of biopsies performed between February 2011 and July 2013, subsequently submitted to surgery, whose histopathological reports were available in the internal information system. Biopsy results were compared with those observed at surgery and the underestimation rate was calculated by means of specific mathematical equations. RESULTS: The underestimation rate at CNB was 50% for ADH and 28.57% for DCIS, and at VABB it was 25% for ADH and 14.28% for DCIS. ADH represented 10.25% of all cases undergoing biopsy, whereas DCIS accounted for 23.91%. CONCLUSION: The diagnostic underestimation rate at CNB is two times the rate at VABB. Certainty that the target has been achieved is not the sole determining factor for a reliable diagnosis. Removal of more than 50% of the target lesion should further reduce the risk of underestimation.
Entities:
Keywords:
Breast neoplasia; Core needle biopsy; Diagnostic techniques and procedures; Noninvasive intraductal carcinoma; Vacuum-assisted biopsy
Authors: Jennifer R Kohr; Peter R Eby; Kimberly H Allison; Wendy B DeMartini; Robert L Gutierrez; Sue Peacock; Constance D Lehman Journal: Radiology Date: 2010-02-19 Impact factor: 11.105
Authors: Christoph J Rageth; Elizabeth A M O'Flynn; Katja Pinker; Rahel A Kubik-Huch; Alexander Mundinger; Thomas Decker; Christoph Tausch; Florian Dammann; Pascal A Baltzer; Eva Maria Fallenberg; Maria P Foschini; Sophie Dellas; Michael Knauer; Caroline Malhaire; Martin Sonnenschein; Andreas Boos; Elisabeth Morris; Zsuzsanna Varga Journal: Breast Cancer Res Treat Date: 2018-11-30 Impact factor: 4.872
Authors: Linei Augusta Brolini Dellê Urban; Luciano Fernandes Chala; Selma di Pace Bauab; Marcela Brisighelli Schaefer; Radiá Pereira Dos Santos; Norma Medicis de Albuquerque Maranhão; Ana Lucia Kefalas; José Michel Kalaf; Carlos Alberto Pecci Ferreira; Ellyete de Oliveira Canella; João Emílio Peixoto; Heverton Leal Ernesto de Amorim; Helio Sebastião Amâncio de Camargo Junior Journal: Radiol Bras Date: 2017 Jul-Aug
Authors: Vera Christina Camargo de Siqueira Ferreira; Elba Cristina Sá de Camargo Etchebehere; José Luiz Barbosa Bevilacqua; Nestor de Barros Journal: Radiol Bras Date: 2018 Mar-Apr
Authors: Christoph J Rageth; Ravit Rubenov; Cristian Bronz; Daniel Dietrich; Christoph Tausch; Ann-Katrin Rodewald; Zsuzsanna Varga Journal: Breast Cancer Date: 2018-12-27 Impact factor: 4.239