Lumarie Santiago1, Beatriz E Adrada2, Monica L Huang2, Wei Wei3, Rosalind P Candelaria2. 1. Department of Diagnostic Radiology, Unit 1350, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA. lumarie.santiago@mdanderson.org. 2. Department of Diagnostic Radiology, Unit 1350, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA. 3. Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Abstract
PURPOSE: To identify clinicopathologic, technical, and imaging features associated with neoplastic seeding (NS) following image-guided needle breast biopsy. METHODS: We performed an institutional review board-approved retrospective review of patients presenting with a new diagnosis of breast cancer or suspicious breast findings requiring biopsy with subsequent diagnosis of NS. The time from biopsy to NS diagnosis was calculated. Histology, grade, estrogen receptor (ER) status, progesterone receptor (PR) status, HER2 status, T category, and N category were recorded. Biopsy guidance method, needle gauge, and number of passes were reviewed in addition to the mammographic and sonographic features of the primary tumors and the NS. RESULTS: Eight cases of NS were identified in 4010 patients. The mean time from biopsy to NS diagnosis was 60.8 days. The most frequent histology was invasive ductal carcinoma (7/8). Six cases were grade 3 (75.0%). Five primary breast cancers were ER, PR, and HER2 negative (62.5%). Seven patients underwent biopsy with ultrasound guidance. Multiple-insertion, non-coaxial ultrasound-guided core-needle biopsy was done in 6 cases. Mammographic presentation of NS was focal asymmetry (3/7 cases), mass (1/7), calcifications only (1/7), or occult (2/7). Sonographic presentation of NS was most often a mass (7/8) with irregular shape (5/7) and without circumscribed margins (6/7) and was occult in 1 case (1/8). NS distribution was subdermal and intradermal. CONCLUSION: High-grade, triple-negative breast cancers and multiple-insertion, non-coaxial biopsies may be risk factors for NS. NS should be suspected on the basis of the superficial and linear pattern of disease progression in these patients.
PURPOSE: To identify clinicopathologic, technical, and imaging features associated with neoplastic seeding (NS) following image-guided needle breast biopsy. METHODS: We performed an institutional review board-approved retrospective review of patients presenting with a new diagnosis of breast cancer or suspicious breast findings requiring biopsy with subsequent diagnosis of NS. The time from biopsy to NS diagnosis was calculated. Histology, grade, estrogen receptor (ER) status, progesterone receptor (PR) status, HER2 status, T category, and N category were recorded. Biopsy guidance method, needle gauge, and number of passes were reviewed in addition to the mammographic and sonographic features of the primary tumors and the NS. RESULTS: Eight cases of NS were identified in 4010 patients. The mean time from biopsy to NS diagnosis was 60.8 days. The most frequent histology was invasive ductal carcinoma (7/8). Six cases were grade 3 (75.0%). Five primary breast cancers were ER, PR, and HER2 negative (62.5%). Seven patients underwent biopsy with ultrasound guidance. Multiple-insertion, non-coaxial ultrasound-guided core-needle biopsy was done in 6 cases. Mammographic presentation of NS was focal asymmetry (3/7 cases), mass (1/7), calcifications only (1/7), or occult (2/7). Sonographic presentation of NS was most often a mass (7/8) with irregular shape (5/7) and without circumscribed margins (6/7) and was occult in 1 case (1/8). NS distribution was subdermal and intradermal. CONCLUSION: High-grade, triple-negative breast cancers and multiple-insertion, non-coaxial biopsies may be risk factors for NS. NS should be suspected on the basis of the superficial and linear pattern of disease progression in these patients.
Entities:
Keywords:
Breast cancer; Immunohistochemical prognostic factors; Tumor prognostic factors
Authors: Ulrich Bick; Rubina M Trimboli; Alexandra Athanasiou; Corinne Balleyguier; Pascal A T Baltzer; Maria Bernathova; Krisztina Borbély; Boris Brkljacic; Luca A Carbonaro; Paola Clauser; Enrico Cassano; Catherine Colin; Gul Esen; Andrew Evans; Eva M Fallenberg; Michael H Fuchsjaeger; Fiona J Gilbert; Thomas H Helbich; Sylvia H Heywang-Köbrunner; Michel Herranz; Karen Kinkel; Fleur Kilburn-Toppin; Christiane K Kuhl; Mihai Lesaru; Marc B I Lobbes; Ritse M Mann; Laura Martincich; Pietro Panizza; Federica Pediconi; Ruud M Pijnappel; Katja Pinker; Simone Schiaffino; Tamar Sella; Isabelle Thomassin-Naggara; Anne Tardivon; Chantal Van Ongeval; Matthew G Wallis; Sophia Zackrisson; Gabor Forrai; Julia Camps Herrero; Francesco Sardanelli Journal: Insights Imaging Date: 2020-02-05