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

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    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
    Issue Date
    2012-02-01T10:34:04Z
    MeSH
    Biopsy
    Biopsy, Needle/methods
    Breast Neoplasms/*pathology/radiography
    Diagnosis, Differential
    Epidemiologic Methods
    Female
    Humans
    Mammography
    Middle Aged
    
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    Citation
    J Clin Pathol. 2009 Dec;62(12):1136-40.
    Journal
    Journal of clinical pathology
    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
    ISSN
    1472-4146 (Electronic)
    0021-9746 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1136/jcp.2009.067280
    Scopus Count
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    St. Vincent's University Hospital

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