Magnetic resonance imaging-guided core needle breast biopsies resulting in high-risk histopathologic findings: Upstage frequency and lesion characteristics

R. Jared Weinfurtner, Bhavika Patel, Christine Laronga, Marie C. Lee, Shannon L. Falcon, Blaise P. Mooney, Binglin Yue, Jennifer S. Drukteinis

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

Introduction The purpose of the present study was to determine the malignancy upstage rates and imaging features of high-risk histopathologic findings resulting from magnetic resonance imaging (MRI)-guided core needle breast biopsies. These features include atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), flat epithelial atypia (FEA), and lobular carcinoma in situ (LCIS). Materials and Methods A retrospective medical record review was performed on all MRI-guided core needle breast biopsies at a single institution from June 1, 2007 to December 1, 2013 to select biopsies yielding high-risk histopathologic findings. The patient demographics, MRI lesion characteristics, and histopathologic features at biopsy and surgical excision were analyzed. Results A total of 257 MRI-guided biopsies had been performed, and 50 yielded high-risk histopathologic features (19%). Biopsy site and surgical excision site correlation was confirmed in 29 of 50 cases. Four of 29 lesions (14%) were upstaged: 1 case to invasive ductal carcinoma and 3 cases to ductal carcinoma in situ. ADH alone had an overall upstage rate of 7% (1 of 14), mixed ADH/ALH a rate of 75% (3 of 4), ALH alone or with LCIS a rate of 0% (0 of 7), and FEA a rate of 0% (0 of 4). Only mixed ADH/ALH had a statistically significant upstage rate to malignancy compared with the other high-risk histopathologic subtypes combined. No specific imaging characteristics on MRI were associated with an upstage to malignancy on the statistical analysis. Conclusion MRI-guided breast biopsies yielding high-risk histopathologic features were associated with an overall upstage to malignancy rate of 14% at surgical excision. All upstaged lesions were associated with ADH. FEA and ALH alone or with LCIS were not associated with an upstage to malignancy.

Original languageEnglish (US)
Pages (from-to)234-239
Number of pages6
JournalClinical Breast Cancer
Volume15
Issue number3
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

Fingerprint

Large-Core Needle Biopsy
Carcinoma, Intraductal, Noninfiltrating
Breast
Hyperplasia
Magnetic Resonance Imaging
Image-Guided Biopsy
Neoplasms
Biopsy
Ductal Carcinoma
Medical Records
Demography
Breast Carcinoma In Situ

Keywords

  • Atypia
  • Atypical ductal hyperplasia
  • Atypical lobular hyperplasia
  • Flat epithelial atypia
  • Lobular carcinoma in situ
  • MRI-guided breast biopsy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Magnetic resonance imaging-guided core needle breast biopsies resulting in high-risk histopathologic findings : Upstage frequency and lesion characteristics. / Weinfurtner, R. Jared; Patel, Bhavika; Laronga, Christine; Lee, Marie C.; Falcon, Shannon L.; Mooney, Blaise P.; Yue, Binglin; Drukteinis, Jennifer S.

In: Clinical Breast Cancer, Vol. 15, No. 3, 01.06.2015, p. 234-239.

Research output: Contribution to journalReview article

Weinfurtner, R. Jared ; Patel, Bhavika ; Laronga, Christine ; Lee, Marie C. ; Falcon, Shannon L. ; Mooney, Blaise P. ; Yue, Binglin ; Drukteinis, Jennifer S. / Magnetic resonance imaging-guided core needle breast biopsies resulting in high-risk histopathologic findings : Upstage frequency and lesion characteristics. In: Clinical Breast Cancer. 2015 ; Vol. 15, No. 3. pp. 234-239.
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abstract = "Introduction The purpose of the present study was to determine the malignancy upstage rates and imaging features of high-risk histopathologic findings resulting from magnetic resonance imaging (MRI)-guided core needle breast biopsies. These features include atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), flat epithelial atypia (FEA), and lobular carcinoma in situ (LCIS). Materials and Methods A retrospective medical record review was performed on all MRI-guided core needle breast biopsies at a single institution from June 1, 2007 to December 1, 2013 to select biopsies yielding high-risk histopathologic findings. The patient demographics, MRI lesion characteristics, and histopathologic features at biopsy and surgical excision were analyzed. Results A total of 257 MRI-guided biopsies had been performed, and 50 yielded high-risk histopathologic features (19{\%}). Biopsy site and surgical excision site correlation was confirmed in 29 of 50 cases. Four of 29 lesions (14{\%}) were upstaged: 1 case to invasive ductal carcinoma and 3 cases to ductal carcinoma in situ. ADH alone had an overall upstage rate of 7{\%} (1 of 14), mixed ADH/ALH a rate of 75{\%} (3 of 4), ALH alone or with LCIS a rate of 0{\%} (0 of 7), and FEA a rate of 0{\%} (0 of 4). Only mixed ADH/ALH had a statistically significant upstage rate to malignancy compared with the other high-risk histopathologic subtypes combined. No specific imaging characteristics on MRI were associated with an upstage to malignancy on the statistical analysis. Conclusion MRI-guided breast biopsies yielding high-risk histopathologic features were associated with an overall upstage to malignancy rate of 14{\%} at surgical excision. All upstaged lesions were associated with ADH. FEA and ALH alone or with LCIS were not associated with an upstage to malignancy.",
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T1 - Magnetic resonance imaging-guided core needle breast biopsies resulting in high-risk histopathologic findings

T2 - Upstage frequency and lesion characteristics

AU - Weinfurtner, R. Jared

AU - Patel, Bhavika

AU - Laronga, Christine

AU - Lee, Marie C.

AU - Falcon, Shannon L.

AU - Mooney, Blaise P.

AU - Yue, Binglin

AU - Drukteinis, Jennifer S.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Introduction The purpose of the present study was to determine the malignancy upstage rates and imaging features of high-risk histopathologic findings resulting from magnetic resonance imaging (MRI)-guided core needle breast biopsies. These features include atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), flat epithelial atypia (FEA), and lobular carcinoma in situ (LCIS). Materials and Methods A retrospective medical record review was performed on all MRI-guided core needle breast biopsies at a single institution from June 1, 2007 to December 1, 2013 to select biopsies yielding high-risk histopathologic findings. The patient demographics, MRI lesion characteristics, and histopathologic features at biopsy and surgical excision were analyzed. Results A total of 257 MRI-guided biopsies had been performed, and 50 yielded high-risk histopathologic features (19%). Biopsy site and surgical excision site correlation was confirmed in 29 of 50 cases. Four of 29 lesions (14%) were upstaged: 1 case to invasive ductal carcinoma and 3 cases to ductal carcinoma in situ. ADH alone had an overall upstage rate of 7% (1 of 14), mixed ADH/ALH a rate of 75% (3 of 4), ALH alone or with LCIS a rate of 0% (0 of 7), and FEA a rate of 0% (0 of 4). Only mixed ADH/ALH had a statistically significant upstage rate to malignancy compared with the other high-risk histopathologic subtypes combined. No specific imaging characteristics on MRI were associated with an upstage to malignancy on the statistical analysis. Conclusion MRI-guided breast biopsies yielding high-risk histopathologic features were associated with an overall upstage to malignancy rate of 14% at surgical excision. All upstaged lesions were associated with ADH. FEA and ALH alone or with LCIS were not associated with an upstage to malignancy.

AB - Introduction The purpose of the present study was to determine the malignancy upstage rates and imaging features of high-risk histopathologic findings resulting from magnetic resonance imaging (MRI)-guided core needle breast biopsies. These features include atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), flat epithelial atypia (FEA), and lobular carcinoma in situ (LCIS). Materials and Methods A retrospective medical record review was performed on all MRI-guided core needle breast biopsies at a single institution from June 1, 2007 to December 1, 2013 to select biopsies yielding high-risk histopathologic findings. The patient demographics, MRI lesion characteristics, and histopathologic features at biopsy and surgical excision were analyzed. Results A total of 257 MRI-guided biopsies had been performed, and 50 yielded high-risk histopathologic features (19%). Biopsy site and surgical excision site correlation was confirmed in 29 of 50 cases. Four of 29 lesions (14%) were upstaged: 1 case to invasive ductal carcinoma and 3 cases to ductal carcinoma in situ. ADH alone had an overall upstage rate of 7% (1 of 14), mixed ADH/ALH a rate of 75% (3 of 4), ALH alone or with LCIS a rate of 0% (0 of 7), and FEA a rate of 0% (0 of 4). Only mixed ADH/ALH had a statistically significant upstage rate to malignancy compared with the other high-risk histopathologic subtypes combined. No specific imaging characteristics on MRI were associated with an upstage to malignancy on the statistical analysis. Conclusion MRI-guided breast biopsies yielding high-risk histopathologic features were associated with an overall upstage to malignancy rate of 14% at surgical excision. All upstaged lesions were associated with ADH. FEA and ALH alone or with LCIS were not associated with an upstage to malignancy.

KW - Atypia

KW - Atypical ductal hyperplasia

KW - Atypical lobular hyperplasia

KW - Flat epithelial atypia

KW - Lobular carcinoma in situ

KW - MRI-guided breast biopsy

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