Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study.
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Oktay Ayşenur, Aslan Özge, Taşkın Füsun, Tunçbilek Nermin, Esen İçten Selma Gül, Balcı Pınar, Arıbal Mustafa Erkin, Çelik Levent, Örgüç İhsan Şebnem, Başaran Demirkazık Figen, Gültekin Serap, Aydın Ayşe Murat, Durmaz Emel, Kul Sibel, Binokay Figen, Çetin Meltem, Emlik Ganime Dilek, Akpınar Meltem Gülsün, Kadıoğlu Voyvoda Sadiye Nuray, Polat Ahmet Veysel, Başara Akın Işıl, Yıldız Şeyma, Poyraz Necdet, Özsoy Arzu, Öztekin Pelin Seher, Elverici Eda, Bayrak İlkay Koray, İkizceli Türkan, Dinç Funda, Sezgin Gülten, Gülşen Gökçe, Tunçbilek Işıl, Yalçın Sabiha Rabia, Çolakoğlu Gül, Ağlamış Serpil, Yılmaz Ravza, Rona Günay, Durhan Gamze, Güner Davut Can, Çelik Yabul Fatma, Günbey Karabekmez Leman, Tutar Burçin, Göktaş Muhammet, Buğdaycı Onur, Suner Aslı, Özdemirhttps/Orcid Org/ Necmettin
Аннотация
METHODS: This retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson's chi-squared test, the Fisher-Freeman-Halton test, and Fisher's exact test were used for the statistical analyses.
RESULTS: The overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.
CONCLUSION: ADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision.