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Published in: Breast Cancer 2/2010

01-04-2010 | Original Article

False-negative ultrasound-guided vacuum-assisted biopsy of the breast: difference with US-detected and MRI-detected lesions

Authors: Naomi Sakamoto, Mitsuhiro Tozaki, Kuniki Higa, Satoko Abe, Shinji Ozaki, Eisuke Fukuma

Published in: Breast Cancer | Issue 2/2010

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Abstract

Background

The purpose of this study was to retrospectively examine the frequency and causes of a false-negative result of ultrasound (US)-guided vacuum-assisted biopsy.

Methods

A retrospective review was performed of 835 patients with 986 consecutive lesions who had undergone US-guided vacuum-assisted biopsy (US-VAB) using 11-gauge probes. We divided the lesions into two groups (US-detected and MRI-detected lesions). The sizes of the lesions on US, number of cores taken, rates of repeat biopsy, and the false-negative rate were compared between the two groups.

Results

The overall false-negative rate of US-VAB was 7.4% (13/175). The final number of malignant pathologic diagnoses was 175 (18%), including 13 false-negative lesions and 6 upgraded high-risk lesions. The false-negative rate for MRI-detected lesions (26%; 8/31) was significantly higher than that for US-detected lesions (3.5%; 5/144) (P = 0.0002). The causes of a false-negative result in the case of US-detected lesions were considered to be technical error in two cases and difficulty in histologic interpretation in three cases. The average size, as measured by US, average number of core samples, and repeat biopsy rate of US-detected lesions and MRI-detected lesions were 11 vs 9.7 mm (P = 0.0005), 13 vs 13 (P = NS), and 7.0% (43/611) vs 9.4% (18/191) (P = NS), respectively.

Conclusion

The high false-negative result for MRI-detected lesions might arise from the difficulties in MRI–US correlation, which indicates the need for MRI-guided biopsy.
Literature
1.
go back to reference Parker SH, Jobe WE, Dennis MA, Stavros AT, Johnson KK, Yakes WF. US-guided automated large-core breast biopsy. Radiology. 1993;187:507–11.PubMed Parker SH, Jobe WE, Dennis MA, Stavros AT, Johnson KK, Yakes WF. US-guided automated large-core breast biopsy. Radiology. 1993;187:507–11.PubMed
2.
go back to reference Liberman L, Feng TL, Dershaw DD, Morris EA, Abramson AF. Ultrasound-guided core breast biopsy: utility and cost-effectiveness. Radiology. 1998;208:717–23.PubMed Liberman L, Feng TL, Dershaw DD, Morris EA, Abramson AF. Ultrasound-guided core breast biopsy: utility and cost-effectiveness. Radiology. 1998;208:717–23.PubMed
3.
go back to reference Simon JR, Kalbhen CL, Cooper RA, Flisak ME. Accuracy and complication rates of US-guided vacuum-assisted core breast biopsy: initial results. Radiology. 2000;215:694–7.PubMed Simon JR, Kalbhen CL, Cooper RA, Flisak ME. Accuracy and complication rates of US-guided vacuum-assisted core breast biopsy: initial results. Radiology. 2000;215:694–7.PubMed
4.
5.
go back to reference Harvey JA, Moran RE, DeAngelis GA. Technique and pitfalls of ultrasound-guided core-needle biopsy of the breast. Semin Ultrasound CT MR. 2000;21:337–403.CrossRefPubMed Harvey JA, Moran RE, DeAngelis GA. Technique and pitfalls of ultrasound-guided core-needle biopsy of the breast. Semin Ultrasound CT MR. 2000;21:337–403.CrossRefPubMed
6.
go back to reference Burbank F, Parker SH, Fogarty TJ. Stereotactic breast biopsy: improved tissue harvesting with the Mammotome. Am Surg. 1996;62:738–44.PubMed Burbank F, Parker SH, Fogarty TJ. Stereotactic breast biopsy: improved tissue harvesting with the Mammotome. Am Surg. 1996;62:738–44.PubMed
7.
go back to reference Berg WA, Krebs TL, Campassi C, Magder LS, Sun CC. Evaluation of 14- and 11-gauge directional, vacuum-assisted biopsy probes and 14-gauge biopsy guns in a breast parenchymal model. Radiology. 1997;205:203–8.PubMed Berg WA, Krebs TL, Campassi C, Magder LS, Sun CC. Evaluation of 14- and 11-gauge directional, vacuum-assisted biopsy probes and 14-gauge biopsy guns in a breast parenchymal model. Radiology. 1997;205:203–8.PubMed
8.
go back to reference Parker SH, Klaus AJ, McWey PJ, Schilling KJ, Cupples TE, Duchesne N, et al. Sonographically guided directional vacuum-assisted breast biopsy using a handheld device. Am J Roentgenol. 2001;177:405–8. Parker SH, Klaus AJ, McWey PJ, Schilling KJ, Cupples TE, Duchesne N, et al. Sonographically guided directional vacuum-assisted breast biopsy using a handheld device. Am J Roentgenol. 2001;177:405–8.
9.
go back to reference Philpotts LE, Hooley RJ, Lee CH. Comparison of automated versus vacuum-assisted biopsy methods for sonographically guided core biopsy of the breast. Am J Roentgenol. 2003;180:347–51. Philpotts LE, Hooley RJ, Lee CH. Comparison of automated versus vacuum-assisted biopsy methods for sonographically guided core biopsy of the breast. Am J Roentgenol. 2003;180:347–51.
10.
go back to reference Perez-Fuentes JA, Longobardi IR, Acosta VF, Marin CE, Liberman L. Sonographically guided directional vacuum-assisted breast biopsy: preliminary experience in Venezuela. Am J Roentgenol. 2001;177:1459–63. Perez-Fuentes JA, Longobardi IR, Acosta VF, Marin CE, Liberman L. Sonographically guided directional vacuum-assisted breast biopsy: preliminary experience in Venezuela. Am J Roentgenol. 2001;177:1459–63.
11.
go back to reference Cassano E, Urban LA, Pizzamiglio M, Abbate F, Maisonneuve P, Renne G, et al. Ultrasound-guided vacuum-assisted core breast biopsy: experience with 406 cases. Breast Cancer Res Treat. 2007;102:103–10.CrossRefPubMed Cassano E, Urban LA, Pizzamiglio M, Abbate F, Maisonneuve P, Renne G, et al. Ultrasound-guided vacuum-assisted core breast biopsy: experience with 406 cases. Breast Cancer Res Treat. 2007;102:103–10.CrossRefPubMed
12.
go back to reference American College of Radiology. Breast imaging reporting and data system (BI-RADS), 4th ed. Reston, Virginia: American College of Radiology; 2003. American College of Radiology. Breast imaging reporting and data system (BI-RADS), 4th ed. Reston, Virginia: American College of Radiology; 2003.
13.
go back to reference Fischer U, Kopka L, Grabbe E. Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology. 1999;213:881–8.PubMed Fischer U, Kopka L, Grabbe E. Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology. 1999;213:881–8.PubMed
14.
go back to reference Morakkabati-Spitz N, Leutner C, Schild H, Traeber F, Kuhl C. Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI. Eur Radiol. 2005;15:2010–7.CrossRefPubMed Morakkabati-Spitz N, Leutner C, Schild H, Traeber F, Kuhl C. Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI. Eur Radiol. 2005;15:2010–7.CrossRefPubMed
15.
go back to reference Tozaki M, Igarashi T, Fukuda K. Breast MRI using the VIBE sequence: clustered ring enhancement in the differential diagnosis of lesions showing non-masslike enhancement. Am J Roentgenol. 2006;187:313–21.CrossRef Tozaki M, Igarashi T, Fukuda K. Breast MRI using the VIBE sequence: clustered ring enhancement in the differential diagnosis of lesions showing non-masslike enhancement. Am J Roentgenol. 2006;187:313–21.CrossRef
16.
go back to reference Sakamoto N, Tozaki M, Higa K, Tsunoda Y, Ogawa T, Abe S, et al. Categorization of non-mass-like breast lesions detected by MRI. Breast Cancer. 2008;15:241–6.CrossRefPubMed Sakamoto N, Tozaki M, Higa K, Tsunoda Y, Ogawa T, Abe S, et al. Categorization of non-mass-like breast lesions detected by MRI. Breast Cancer. 2008;15:241–6.CrossRefPubMed
17.
go back to reference Kuhl CK, Morakkabati N, Leutner CC, Schmiedel A, Wardelmann E, Schild HH. MR imaging-guided large-core (14-gauge) needle biopsy of small lesions visible at breast MR imaging alone. Radiology. 2001;220:31–9.PubMed Kuhl CK, Morakkabati N, Leutner CC, Schmiedel A, Wardelmann E, Schild HH. MR imaging-guided large-core (14-gauge) needle biopsy of small lesions visible at breast MR imaging alone. Radiology. 2001;220:31–9.PubMed
18.
go back to reference Perlet C, Heywang-Kobrunner SH, Heinig A, Sittek H, Casselman J, Anderson I, et al. Magnetic resonance-guided, vacuum-assisted breast biopsy: results from a European multicenter study of 538 lesions. Cancer. 2006;106:982–90.CrossRefPubMed Perlet C, Heywang-Kobrunner SH, Heinig A, Sittek H, Casselman J, Anderson I, et al. Magnetic resonance-guided, vacuum-assisted breast biopsy: results from a European multicenter study of 538 lesions. Cancer. 2006;106:982–90.CrossRefPubMed
19.
go back to reference Tozaki M, Yamashiro N, Suzuki T, Kawano N, Ozaki S, Sakamoto N, Abe S, Ogawa T, Katayama N, Tsunoda Y, Fukuma E. MR-guided vacuum-assisted breast biopsy: is it an essential technique? Breast Cancer. 2008 Sep 20. Tozaki M, Yamashiro N, Suzuki T, Kawano N, Ozaki S, Sakamoto N, Abe S, Ogawa T, Katayama N, Tsunoda Y, Fukuma E. MR-guided vacuum-assisted breast biopsy: is it an essential technique? Breast Cancer. 2008 Sep 20.
20.
go back to reference Gobbi H, Simpson JF, Borowsky A, Jensen RA, Page DL. Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence. Cancer. 1999;85:2170–82.CrossRefPubMed Gobbi H, Simpson JF, Borowsky A, Jensen RA, Page DL. Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence. Cancer. 1999;85:2170–82.CrossRefPubMed
21.
go back to reference Sneige N, Yaziji H, Mandavilli SR, Perez ER, Ordonez NG, Gown AM, et al. Low-grade (fibromatosis-like) spindle cell carcinoma of the breast. Am J Surg Pathol. 2001;25:1009–16.CrossRefPubMed Sneige N, Yaziji H, Mandavilli SR, Perez ER, Ordonez NG, Gown AM, et al. Low-grade (fibromatosis-like) spindle cell carcinoma of the breast. Am J Surg Pathol. 2001;25:1009–16.CrossRefPubMed
22.
go back to reference Ivan D, Selinko V, Sahin AA, Sneige N, Middleton LP. Accuracy of core needle biopsy diagnosis in assessing papillary breast lesions: histologic predictors of malignancy. Mod Pathol. 2004;17:165–71.CrossRefPubMed Ivan D, Selinko V, Sahin AA, Sneige N, Middleton LP. Accuracy of core needle biopsy diagnosis in assessing papillary breast lesions: histologic predictors of malignancy. Mod Pathol. 2004;17:165–71.CrossRefPubMed
23.
go back to reference Rosen EL, Bentley RC, Baker JA. Imaging-guided core needle biopsy of papillary lesions of the breast. Am J Roentgenol. 2002;179:1185–92. Rosen EL, Bentley RC, Baker JA. Imaging-guided core needle biopsy of papillary lesions of the breast. Am J Roentgenol. 2002;179:1185–92.
24.
go back to reference Sydnor MK, Wilson JD, Hijaz TA, Massey HD, Shaw de Paredes ES. Underestimation of the presence of breast carcinoma in papillary lesions initially diagnosed at core-needle biopsy. Radiology. 2007;242:58–62.CrossRefPubMed Sydnor MK, Wilson JD, Hijaz TA, Massey HD, Shaw de Paredes ES. Underestimation of the presence of breast carcinoma in papillary lesions initially diagnosed at core-needle biopsy. Radiology. 2007;242:58–62.CrossRefPubMed
25.
go back to reference Renshaw AA, Derhagopian RP, Tizol-Blanco DM, Gould EW. Papillomas and atypical papillomas in breast core needle biopsy specimens: risk of carcinoma in subsequent excision. Am J Clin Pathol. 2004;122:217–21.CrossRefPubMed Renshaw AA, Derhagopian RP, Tizol-Blanco DM, Gould EW. Papillomas and atypical papillomas in breast core needle biopsy specimens: risk of carcinoma in subsequent excision. Am J Clin Pathol. 2004;122:217–21.CrossRefPubMed
26.
go back to reference Liberman L, Tornos C, Huzjan R, Bartella L, Morris EA, Dershaw DD. Is surgical excision warranted after benign, concordant diagnosis of papilloma at percutaneous breast biopsy? Am J Roentgenol. 2006;186:1328–34.CrossRef Liberman L, Tornos C, Huzjan R, Bartella L, Morris EA, Dershaw DD. Is surgical excision warranted after benign, concordant diagnosis of papilloma at percutaneous breast biopsy? Am J Roentgenol. 2006;186:1328–34.CrossRef
27.
go back to reference Mercado CL, Hamele-Bena D, Oken SM, Singer CI, Cangiarella J. Papillary lesions of the breast at percutaneous core-needle biopsy. Radiology. 2006;238:801–8.CrossRefPubMed Mercado CL, Hamele-Bena D, Oken SM, Singer CI, Cangiarella J. Papillary lesions of the breast at percutaneous core-needle biopsy. Radiology. 2006;238:801–8.CrossRefPubMed
28.
go back to reference Jacobs TW, Connolly JL, Schnitt SJ. Nonmalignant lesions in breast core needle biopsies: to excise or not to excise? Am J Surg Pathol. 2002;26:1095–110.CrossRefPubMed Jacobs TW, Connolly JL, Schnitt SJ. Nonmalignant lesions in breast core needle biopsies: to excise or not to excise? Am J Surg Pathol. 2002;26:1095–110.CrossRefPubMed
29.
go back to reference Fenoglio C, Lattes R. Sclerosing papillary proliferations in the female breast: a benign lesion often mistaken for carcinoma. Cancer. 1974;33:691–700.CrossRefPubMed Fenoglio C, Lattes R. Sclerosing papillary proliferations in the female breast: a benign lesion often mistaken for carcinoma. Cancer. 1974;33:691–700.CrossRefPubMed
30.
go back to reference Carter D. Intraductal papillary tumors of the breast: a study of 78 cases. Cancer. 1977;39:1689–92.CrossRefPubMed Carter D. Intraductal papillary tumors of the breast: a study of 78 cases. Cancer. 1977;39:1689–92.CrossRefPubMed
31.
go back to reference Tavassoli FA. Papillary lesions. In: Tavassoli FA, editor. Pathology of the breast. Norwalk: Appleton & Lange; 1992. p. 193–227. Tavassoli FA. Papillary lesions. In: Tavassoli FA, editor. Pathology of the breast. Norwalk: Appleton & Lange; 1992. p. 193–227.
32.
go back to reference Shin HJ, Kim HH, Kim SM, Yang HR, Sohn JH, Kwon GY, et al. Papillary lesions of the breast diagnosed at percutaneous sonographically guided biopsy: comparison of sonographic features and biopsy methods. Am J Roentgenol. 2008;190:630–6.CrossRef Shin HJ, Kim HH, Kim SM, Yang HR, Sohn JH, Kwon GY, et al. Papillary lesions of the breast diagnosed at percutaneous sonographically guided biopsy: comparison of sonographic features and biopsy methods. Am J Roentgenol. 2008;190:630–6.CrossRef
33.
go back to reference Shah VI, Raju U, Chitale D, Deshpande V, Gregory N, Strand V. False-negative core needle biopsies of the breast: an analysis of clinical, radiologic, and pathologic findings in 27 consecutive cases of missed breast cancer. Cancer. 2003;97:1824–31.CrossRefPubMed Shah VI, Raju U, Chitale D, Deshpande V, Gregory N, Strand V. False-negative core needle biopsies of the breast: an analysis of clinical, radiologic, and pathologic findings in 27 consecutive cases of missed breast cancer. Cancer. 2003;97:1824–31.CrossRefPubMed
Metadata
Title
False-negative ultrasound-guided vacuum-assisted biopsy of the breast: difference with US-detected and MRI-detected lesions
Authors
Naomi Sakamoto
Mitsuhiro Tozaki
Kuniki Higa
Satoko Abe
Shinji Ozaki
Eisuke Fukuma
Publication date
01-04-2010
Publisher
Springer Japan
Published in
Breast Cancer / Issue 2/2010
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-009-0112-1

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