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DOI 10.3389/fonc.2025.1618476

Медицинская библиотека · Frontiers in oncology · 2025

Vacuum-assisted biopsy in the era of low-risk ductal carcinoma in situ active monitoring: real world data and implications.

Couto Henrique Lima, Valadares Carolina Nazareth, Soares Aleida Nazareth, Ricardo Bernardo Ferreira de Paula, Toppa Paola Hartung, Coelho Bertha Andrade, Pessoa Eduardo Carvalho, Resende Vivian, Ferreira Tereza Cristina de Oliveira, Mattar Andre, Amorim Andressa, Clarke Paula, Freitas-Junior Rufo, Silva Junior Gabriel de Almeida, Sharma Nisha, Bartels Henrique Silva, de Paula Charles Andreé Joseph, Cunha Júnior Geraldo Felício, Oliveira Dênia Reis de Paula, Silvestre da Silva Bruna Torres, Siqueira Daniela Rodrigues, Castilho Marcus Simões, Antonini Marcelo, de Amorim Heverton Leal Ernesto, de Oliveira Jane Sanglard, Pires Bruna Antunes de Miranda, Pires Douglas de Miranda, Ferreira Shirley das Graças, Moraes Thais Paiva, Oliveira Larissa Barbosa, Soares Paula Martins Cristina, de Oliveira Vilmar Marques, Dos Santos Annamaria Massaud Rodrigues, Rahal Rosemar Macedo Souza, Hassan Augusto Tufi, de Lucena Clécio Ênio Murta, Tosello Giuliano, Buttros Daniel de Araújo Brito, Novita Guilherme, Saliba Romana Giordana Ribeiro, Carvalho Bárbara Pace Silva Assis, de Almeida Junior Waldeir José, Ramos Marcellus do Nascimento Moreira, Mendonça Ana Carolina Guglielmelli, Reis Fernando Marcos

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Аннотация

BACKGROUND

The short-term oncological safe of active monitoring for ductal carcinoma in situ (DCIS) with low risk (LR-DCIS) of progression to invasive cancers (IC) has been demonstrated. This study evaluates vacuum assisted biopsy (VAB) as diagnostic test for LR-DCIS active monitoring (AM) in real-world clinical practice.

METHODS

Database analysis of 116 cancers [both invasive breast cancers (IC) and ductal carcinoma in situ (DCIS)] diagnosed by VAB submitted to standard surgical treatment with complete histological data from VAB and surgery from 04/13/2017 to 11/28/2020. The VAB results matched the surgical pathology, considered the gold standard, and AM criteria. The pathological diagnoses were grouped into malignancies requiring guideline surgical treatment [DCIS with high risk (HR-DCIS) of progression to IC or IC] versus those eligible to alternative AM (LR-DCIS). HR-DCIS/IC were considered positive while LR-DCIS negative results. VAB sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were obtained.

RESULTS

Mean age 55.6 [± 12.27]; mean IC size 7.14 [± 5.17]mm and 12.6 [± 11.63]mm for DCIS. Out of 116 malignancies diagnosed by VAB, 15 (12.9%) resulted LR-DCIS in the biopsy, 10 (8.6%) confirmed LR-DCIS in surgery, and 5 (4.3%) upgraded to HR-DCIS/IC in surgery. VAB showed 95.28% (89.3-98.5; 95% CI) sensitivity, 100% (69.2-100; 95% CI) specificity, PPV was 100% (96.4-100; 95% CI), and NPV 66.67% (38.4-88.2; 95% CI). VAB LR-DCIS AM was 6.9% (8/116) and underdiagnoses 2.6% (2 pT1a-bN0 hormone receptor positive and 1 HR-DCIS).

CONCLUSION

VAB LR-DCIS AM would lead to a moderate (6.9%) overall reduction of short-term breast cancer surgical overtreatment counterbalanced by a low rate (2.6%) of underdiagnosed HR-DCIS/IC potentially treatable by adjuvant hormone therapy.

CLINICAL TRIAL REGISTRATION: https://plataformabrasil.saude.gov.br/visao/pesquisador/gerirPesquisa/gerirPesquisaAgrupador.jsf, identifier 25761019.8.0000.5138.

Для цитирования: Couto Henrique Lima, Valadares Carolina Nazareth, Soares Aleida Nazareth, Ricardo Bernardo Ferreira de Paula, Toppa Paola Hartung, Coelho Bertha Andrade, Pessoa Eduardo Carvalho, Resende Vivian, Ferreira Tereza Cristina de Oliveira, Mattar Andre, Amorim Andressa, Clarke Paula, Freitas-Junior Rufo, Silva Junior Gabriel de Almeida, Sharma Nisha, Bartels Henrique Silva, de Paula Charles Andreé Joseph, Cunha Júnior Geraldo Felício, Oliveira Dênia Reis de Paula, Silvestre da Silva Bruna Torres, Siqueira Daniela Rodrigues, Castilho Marcus Simões, Antonini Marcelo, de Amorim Heverton Leal Ernesto, de Oliveira Jane Sanglard, Pires Bruna Antunes de Miranda, Pires Douglas de Miranda, Ferreira Shirley das Graças, Moraes Thais Paiva, Oliveira Larissa Barbosa, Soares Paula Martins Cristina, de Oliveira Vilmar Marques, Dos Santos Annamaria Massaud Rodrigues, Rahal Rosemar Macedo Souza, Hassan Augusto Tufi, de Lucena Clécio Ênio Murta, Tosello Giuliano, Buttros Daniel de Araújo Brito, Novita Guilherme, Saliba Romana Giordana Ribeiro, Carvalho Bárbara Pace Silva Assis, de Almeida Junior Waldeir José, Ramos Marcellus do Nascimento Moreira, Mendonça Ana Carolina Guglielmelli, Reis Fernando Marcos. Vacuum-assisted biopsy in the era of low-risk ductal carcinoma in situ active monitoring: real world data and implications.. Frontiers in oncology. 2025. DOI: 10.3389/fonc.2025.1618476.
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