Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience.

Hdl Handle:
http://hdl.handle.net/10147/207654
Title:
Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience.
Authors:
Hayes, B D; O'Doherty, A; Quinn, C M
Affiliation:
Department of Histopathology, St Vincent's University Hospital, Dublin 4,, Ireland. brian_hayes@ireland.com
Citation:
J Clin Pathol. 2009 Dec;62(12):1136-40.
Journal:
Journal of clinical pathology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207654
DOI:
10.1136/jcp.2009.067280
PubMed ID:
19946101
Abstract:
AIMS: Needle core biopsy (NCB) is a widely-used technique for non-operative evaluation of screen-detected breast lesions. Although most NCBs are B2 (benign) or B5 (malignant), some fall into the B3 category of "uncertain malignant potential". This study aims to categorise the lesions prompting a B3 NCB in the Merrion Breast Screening Unit, and establish the incidence of malignancy on subsequent excision biopsy. METHODS: Patients attending the Merrion Breast Screening Unit in Dublin between 2000 and 2008 who had a B3 NCB were identified. The NCB pathology reports were reviewed and the diagnosis correlated with excision histology; the latter was classified as benign, atypical or malignant. Lesion-specific positive predictive values (PPVs) for malignancy were derived. RESULTS: 141 patients with a B3 NCB were identified. The most frequent lesions on NCB were radial scar (RS; n = 57), atypical intraductal epithelial proliferation (AIDEP; n = 25) and papillary lesion (n = 24). The final diagnosis was malignant in 22 patients (16%), atypical in 40 (28%) and benign in 79 (56%). Two of the patients with a malignant diagnosis had invasive carcinoma. The lesion-specific PPVs were: lobular neoplasia 50%, AIDEP 32%, columnar cell lesion with atypia 12.5%, RS 12.3%, papillary lesion 8.3%, suspected phyllodes tumour 7.7%, and spindle cell lesion 0%. Atypia on RS NCB predicted an atypical or malignant excision diagnosis, but atypia on papillary lesion NCB did not. CONCLUSIONS: One-sixth of B3 NCBs in this series proved to be malignant on excision. The PPV for malignancy varied according to lesion type.
Language:
eng
MeSH:
Biopsy; Biopsy, Needle/methods; Breast Neoplasms/*pathology/radiography; Diagnosis, Differential; Epidemiologic Methods; Female; Humans; Mammography; Middle Aged
ISSN:
1472-4146 (Electronic); 0021-9746 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorHayes, B Den_GB
dc.contributor.authorO'Doherty, Aen_GB
dc.contributor.authorQuinn, C Men_GB
dc.date.accessioned2012-02-01T10:34:04Z-
dc.date.available2012-02-01T10:34:04Z-
dc.date.issued2012-02-01T10:34:04Z-
dc.identifier.citationJ Clin Pathol. 2009 Dec;62(12):1136-40.en_GB
dc.identifier.issn1472-4146 (Electronic)en_GB
dc.identifier.issn0021-9746 (Linking)en_GB
dc.identifier.pmid19946101en_GB
dc.identifier.doi10.1136/jcp.2009.067280en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207654-
dc.description.abstractAIMS: Needle core biopsy (NCB) is a widely-used technique for non-operative evaluation of screen-detected breast lesions. Although most NCBs are B2 (benign) or B5 (malignant), some fall into the B3 category of "uncertain malignant potential". This study aims to categorise the lesions prompting a B3 NCB in the Merrion Breast Screening Unit, and establish the incidence of malignancy on subsequent excision biopsy. METHODS: Patients attending the Merrion Breast Screening Unit in Dublin between 2000 and 2008 who had a B3 NCB were identified. The NCB pathology reports were reviewed and the diagnosis correlated with excision histology; the latter was classified as benign, atypical or malignant. Lesion-specific positive predictive values (PPVs) for malignancy were derived. RESULTS: 141 patients with a B3 NCB were identified. The most frequent lesions on NCB were radial scar (RS; n = 57), atypical intraductal epithelial proliferation (AIDEP; n = 25) and papillary lesion (n = 24). The final diagnosis was malignant in 22 patients (16%), atypical in 40 (28%) and benign in 79 (56%). Two of the patients with a malignant diagnosis had invasive carcinoma. The lesion-specific PPVs were: lobular neoplasia 50%, AIDEP 32%, columnar cell lesion with atypia 12.5%, RS 12.3%, papillary lesion 8.3%, suspected phyllodes tumour 7.7%, and spindle cell lesion 0%. Atypia on RS NCB predicted an atypical or malignant excision diagnosis, but atypia on papillary lesion NCB did not. CONCLUSIONS: One-sixth of B3 NCBs in this series proved to be malignant on excision. The PPV for malignancy varied according to lesion type.en_GB
dc.language.isoengen_GB
dc.subject.meshBiopsyen_GB
dc.subject.meshBiopsy, Needle/methodsen_GB
dc.subject.meshBreast Neoplasms/*pathology/radiographyen_GB
dc.subject.meshDiagnosis, Differentialen_GB
dc.subject.meshEpidemiologic Methodsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMammographyen_GB
dc.subject.meshMiddle Ageden_GB
dc.titleCorrelation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience.en_GB
dc.contributor.departmentDepartment of Histopathology, St Vincent's University Hospital, Dublin 4,, Ireland. brian_hayes@ireland.comen_GB
dc.identifier.journalJournal of clinical pathologyen_GB
dc.description.provinceLeinster-

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