Underestimation of DCIS at MRI-guided vacuum-assisted breast biopsy Journal Article
| Authors: | Lee, J. M.; Kaplan, J. B.; Murray, M. P.; Mazur Grbac, M.; Tadic, T.; Stimac, D.; Liberman, L. |
| Article Title: | Underestimation of DCIS at MRI-guided vacuum-assisted breast biopsy |
| Abstract: | OBJECTIVE. The study objective was to assess the rate of underestimation of ductal carcinoma in situ (DCIS) at MRI-guided 9-gauge vacuum-assisted breast biopsy. MATERIALS AND METHODS. An institutional review board-approved retrospective review was performed of 373 consecutive lesions that had undergone MRI vacuum-assisted breast biopsy. In 34 lesions with subsequent surgery, vacuum-assisted breast biopsy yielded DCIS without frank microinvasion or invasion. DCIS underestimates were lesions for which vacuum-assisted breast biopsy yielded DCIS without frank microinvasion or invasion at biopsy and surgery yielded invasive cancer. Records and pathology findings were reviewed. RESULTS. Among 34 lesions, vacuum-assisted breast biopsy histology was DCIS in 29 and DCIS with possible microinvasion in five. Of 29 lesions yielding DCIS at MRI vacuum-assisted breast biopsy, surgical excision revealed invasive cancer in five (17%; 95% CI, 6-36%). The DCIS underestimation rate was significantly higher in lesions 6 cm or larger versus smaller lesions (60% vs 8%, p = 0.02). MRI lesion type, kinetics, number of specimens, menopausal status, and target sampling versus excision did not significantly affect underestimation. Of five lesions yielding DCIS with possible microinvasion at MRI vacuum-assisted breast biopsy, surgery revealed invasive carcinoma in four (80%; 95% CI, 28-99%). DCIS underestimation was significantly more likely if MRI vacuum-assisted breast biopsy showed possible microinvasion than if it did not (80% vs 17%, p = 0.01). CONCLUSION. Underestimation occurred in 17% of lesions yielding DCIS and in 80% of lesions yielding DCIS with possible microinvasion at MRI vacuum-assisted breast biopsy. DCIS underestimation was significantly more likely in lesions measuring 6 cm or larger. No other patient or lesion factors significantly affected DCIS underestimation at MRI vacuum-assisted breast biopsy. © American Roentgen Ray Society. |
| Keywords: | adult; clinical article; aged; middle aged; retrospective studies; histopathology; nuclear magnetic resonance imaging; breast cancer; breast neoplasms; medical record review; biopsy; cancer invasion; breast imaging; breast carcinoma; carcinoma in situ; diagnostic error; chi-square distribution; false negative reactions; mri; breast biopsy; magnetic resonance imaging, interventional; vacuum; ductal carcinoma in situ; carcinoma, ductal, breast |
| Journal Title: | American Journal of Roentgenology |
| Volume: | 189 |
| Issue: | 2 |
| ISSN: | 0361-803X |
| Publisher: | American Roentgen Ray Society |
| Date Published: | 2007-08-01 |
| Start Page: | 468 |
| End Page: | 474 |
| Language: | English |
| DOI: | 10.2214/ajr.07.2172 |
| PUBMED: | 17646475 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 9" - "Export Date: 17 November 2011" - "CODEN: AJROA" - "Source: Scopus" |
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