Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience.
Affiliation
Department of Histopathology, St Vincent's University Hospital, Dublin 4,, Ireland. brian_hayes@ireland.comIssue Date
2012-02-01T10:34:04ZMeSH
BiopsyBiopsy, Needle/methods
Breast Neoplasms/*pathology/radiography
Diagnosis, Differential
Epidemiologic Methods
Female
Humans
Mammography
Middle Aged
Metadata
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J Clin Pathol. 2009 Dec;62(12):1136-40.Journal
Journal of clinical pathologyDOI
10.1136/jcp.2009.067280PubMed ID
19946101Abstract
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
engISSN
1472-4146 (Electronic)0021-9746 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1136/jcp.2009.067280