Cancelled stereotactic biopsy of calcifications not seen using the stereotactic technique: Do we still need to biopsy? Journal Article

  

Authors:	Brennan, S. B.; D'alessio, D.; Liberman, L.; Giri, D.; Brogi, E.; Morris, E. A.
Article Title:	Cancelled stereotactic biopsy of calcifications not seen using the stereotactic technique: Do we still need to biopsy?
Abstract:	Objective: To determine the frequency of cancelled stereotactic biopsy due to non-visualisation of calcifications, and assess associated features and outcome data. Methods: A retrospective review was performed on 1,874 patients scheduled for stereotactic-guided breast biopsy from 2009 to 2011. Medical records and imaging studies were reviewed. Results: Of 1,874 stereotactic biopsies, 76 (4 %) were cancelled because of non-visualisation of calcifications. Prompt histological confirmation was obtained in 42/76 (55 %). In 28/76 (37 %) follow-up mammography was performed, and 7/28 subsequently underwent biopsy. Of 27 without biopsy, 21 (78 %) had follow-up. Nine cancers (9/49, 18 %) were found: 6 ductal carcinoma in situ (DCIS), 3 infiltrating ductal carcinoma (IDC). Of 54 patients with either biopsy or at least 2 years' follow-up, 9 (17 %) had cancer (95 % CI 8-29). Cancer was present in 7/42 (17 %, 95 % CI 7-31 %) lesions that had prompt histological confirmation (DCIS = 5, IDC = 2) and in 2/28 (7 %, 95 % CI 0.8-24 %) lesions referred for follow-up (DCIS = 1, IDC = 1). Neither calcification morphology (P = 0.2), patient age (P = 0.7), breast density (P = 1.0), personal history (P = 1.0) nor family history of breast cancer (P = 0.5) had a significant association with cancer. Conclusion: Calcifications not visualised on the stereotactic unit are not definitely benign and require surgical biopsy or follow-up. No patient or morphological features were predictive of cancer. Key points: • Half of cancelled stereotactic biopsies were due to non-visualisation of calcified foci. • This reflects the improved detection of calcifications by digital mammography. • Calcifications too faint for the stereotactic technique require alternative biopsy or follow-up • 17 % of patients with biopsy or at least 2 years' follow-up had cancer. • No patient/morphological features were found to aid selection for re-biopsy vs. follow-up. © 2013 European Society of Radiology.
Keywords:	breast; biopsy; mammography; carcinoma, ductal, breast; calcification, pathological
Journal Title:	European Radiology
Volume:	24
Issue:	4
ISSN:	0938-7994
Publisher:	Springer
Date Published:	2014-04-01
Start Page:	907
End Page:	912
Language:	English
DOI:	10.1007/s00330-013-3055-z
PROVIDER:	scopus
PUBMED:	24217642
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84896313494&partnerID=40&md5=ef32a738747292b179c67c05d569ca2d
Notes:	Export Date: 2 April 2014 -- CODEN: EURAE -- Source: Scopus

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