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Breast Cancer
Published in: Breast Cancer 2/2014

01-03-2014 | Original Article

Underestimation of papillary breast lesions by core biopsy: correlation to surgical excision

Authors: Stamatia Destounis, Posy Seifert, Patricia Somerville, Philip Murphy, Renee Morgan, Andrea Arieno, Wende Logan Young

Published in: Breast Cancer | Issue 2/2014

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Abstract

Background

The purpose of this study was to evaluate papillary lesions of the breast diagnosed at needle core biopsy and the outcomes of follow-up imaging and surgical findings.

Methods

Retrospective review of 13,806 needle core biopsies performed from 2004 to 2010 revealed 352 patients with 368 papillary lesions; 137 of these lesions underwent surgical excision and 215 had a minimum of 2 year imaging follow-up. Outcomes of imaging follow-up and underestimation of carcinoma by comparison to surgical excision, as applicable, were determined. Patient demographics, clinical presentation, BI-RADS® breast density, palpability, biopsy methods, number of specimens, and pathology were recorded. A two-tailed Fisher exact test was used to assess associations between biopsy techniques and the results of surgical excision as well as the association between palpability and the results of surgical excision. SAS® V 9.1.3 was used to perform the calculations.

Results

One hundred and thirty-seven lesions proceeded to surgical excision. A total of 28 lesions were underestimated; 21 of these were underestimated carcinomas. When comparing biopsy devices in the underestimated group, 64 % were biopsied with directional vacuum-assisted devices and 36 % with automated large core devices (p < 0.0706). In total 18 % of the palpable lesions were underestimated, whereas 17 % of the nonpalpable lesions were underestimated (p < 0.6560); this was not a significant difference.

Conclusions

Overall, carcinoma was underestimated at needle biopsy in 6 % (21/368) of papillary lesions diagnosed when compared to surgical excision. In cases that underwent excision, 34 % (47/137) revealed carcinoma; 45 % (21/47) of these were underestimated carcinomas. Lesion palpability and biopsy method did not affect underestimation in this study population.
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Metadata
Title
Underestimation of papillary breast lesions by core biopsy: correlation to surgical excision
Authors
Stamatia Destounis
Posy Seifert
Patricia Somerville
Philip Murphy
Renee Morgan
Andrea Arieno
Wende Logan Young
Publication date
01-03-2014
Publisher
Springer Japan
Published in
Breast Cancer / Issue 2/2014
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-012-0361-2

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