Breast lesions with ultrasound imaging-histologic discordance at 16-gauge core needle biopsy: Can re-biopsy with 10-gauge vacuum-assisted system get definitive diagnosis?

• Published in: Breast (Edinburgh) Vol. 19; no. 6; pp. 446 - 449
• Main Authors: Li, Jun Lai, Wang, Zhi Li, Su, Li, Liu, Xiao Jun, Tang, Jie
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2010
• Subjects: Adult; Aged; Biopsy, Needle - instrumentation; Biopsy, Needle - methods; Breast - pathology; Breast lesions; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Carcinoma in Situ - pathology; Carcinoma, Ductal, Breast - pathology; Carcinoma, Lobular - pathology; Core needle biopsy; Diagnosis, Differential; Female; Hematology, Oncology and Palliative Medicine; Humans; Hyperplasia - pathology; Imaging-histologic discordance; Middle Aged; Predictive Value of Tests; Ultrasonography; Vacuum-assisted biopsy; Vacuum-assisted biopsy; Breast lesions; Imaging-histologic discordance; Core needle biopsy
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/j.breast.2010.04.003

Abstract The aim of this study was to evaluate if re-biopsy with 10-gauge vacuum-assisted biopsy (VAB) could get definitive diagnosis for breast lesions with ultrasound (US) imaging-histologic discordance at 16-gauge core needle biopsy (CNB). From January 2007 to June 2008, a consecutive biopsy was performed on 1069 lesions with US-guided 16-gauge CNB. A total of 28 lesions were considered to be US imaging-histologic discordant and all of them underwent subsequent 10-gauge VAB. All malignant lesions located at VAB were treated with subsequent surgery and all benign lesions at VAB were followed up for at least 1 year. Six of the 28 lesions (21.4%) had pathologic upgrade after VAB. In them, one case upgraded from adenosis to ductal carcinoma in situ (DCIS); one case upgraded from adenosis to infiltrating ductal carcinoma (IDC); one case upgraded from atypical ductal hyperplasia to IDC; two cases upgraded from intraductal papilloma to DCIS; and one case upgraded from sclerosing adenosis to invasive lobular carcinoma (ILC). The subsequent surgery further demonstrated the diagnosis of VAB for all the lesions with histologic upgrade. Re-biopsy could improve diagnostic accuracy in patients with breast lesions showing imaging-histologic discordance during CNB, and 10-gauge VAB was a valuable method to deal with re-biopsy.