Percutaneous Ultrasound-Guided Vacuum-Assisted Removal versus Surgery for Breast Lesions Showing Imaging-Histology Discordance after Ultrasound-Guided Core-Needle Biopsy.
10.3348/kjr.2014.15.6.697
- Author:
Yu Mee SOHN
1
;
Jung Hyun YOON
;
Eun Kyung KIM
;
Hee Jung MOON
;
Min Jung KIM
Author Information
1. Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752, Korea. mines@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Imaging-histologic discordance;
Core needle biopsy;
Vacuum-assisted removal;
Surgical excision
- MeSH:
Adult;
Age Factors;
Aged;
Biopsy, Needle;
Breast/*pathology/surgery;
Breast Neoplasms/pathology/surgery;
False Negative Reactions;
Female;
Follow-Up Studies;
Humans;
*Mammography;
Middle Aged;
Ultrasonography, Interventional;
Vacuum;
Young Adult
- From:Korean Journal of Radiology
2014;15(6):697-703
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the upgrade rate and delayed false-negative results of percutaneous vacuum-assisted removal (VAR) and surgical excision in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy (CNB) of the breast and to validate the role of VAR as a rebiopsy method for these discordant lesions. MATERIALS AND METHODS: Percutaneous US-guided 14-gauge CNB was performed on 7470 patients between August 2005 and December 2010. Our study population included 161 lesions in 152 patients who underwent subsequent rebiopsy due to imaging-histologic discordance. Rebiopsy was performed using VAR (n = 88) or surgical excision (n = 73). We investigated the upgrade rate immediately after rebiopsy and delayed false-negative results during at least 24 months of follow-up after rebiopsy. We also evaluated the clinicoradiological differences between VAR and surgical excision. RESULTS: Total upgrade to malignancy occurred in 13.7% (22/161) of lesions at rebiopsy including both VAR and surgical excision: 4.6% (4/88) of VAR cases (4/88) and 24.7% (18/73) of surgical excision cases (p < 0.001). Surgical excision was performed significantly more frequently in older patients and for larger-sized lesions than that of VAR, and a significant difference was detected between VAR and surgical excision in the Breast Imaging and Reporting and Data System category (p < 0.007). No delayed false-negative results were observed after VAR or surgical excision during the follow-up period. CONCLUSION: Long-term follow-up data showed no delayed cancer diagnoses after US-guided VAR in imaging-histologic discordant lesions of the breast, suggesting that VAR might be a rebiopsy method for these lesions.
