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Large-needle core biopsy: nonmalignant breast abnormalities evaluated with surgical excision or repeat core biopsy
J E Meyer1, D N Smith, S C Lester
1Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Radiology
|March 12, 1998
Summary
Large-needle core biopsy can miss malignancies. Surgical excision or repeat biopsy of initially nonmalignant breast lesions identified 18 additional cancers, improving diagnostic accuracy.
Area of Science:
- Breast oncology
- Diagnostic pathology
- Radiology-pathology correlation
Background:
- Large-needle core biopsy is a primary method for breast lesion evaluation.
- Discordance between imaging, pathology, and clinical findings necessitates further investigation.
Purpose of the Study:
- To classify lesions initially deemed nonmalignant by large-needle core biopsy.
- To assess the diagnostic yield of subsequent surgical excision or repeat biopsy for these lesions.
Main Methods:
- Retrospective review of 1,032 breast abnormalities sampled via large-needle core biopsy (1991-1996).
- Analysis of 112 nonmalignant lesions, focusing on those with discordant findings, potential missed diagnoses, or pathologist recommendations for excision.
- Correlation of technical biopsy quality, imaging features, and pathology.
Main Results:
- No malignancies were found in 24 lesions excised due to discordant findings.
- Two malignancies (infiltrating ductal carcinoma) were identified among 41 possibly missed lesions.
- Sixteen malignancies (including ductal carcinoma in situ and infiltrating ductal carcinoma) were found in 40 lesions recommended for excision.
Conclusions:
- Correlation of biopsy quality, imaging, and pathology led to 96 surgical excisions and 16 repeat biopsies.
- Eighteen additional malignancies were identified in lesions initially classified as nonmalignant, highlighting the importance of follow-up.