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 journalArticle

9 Scopus citations

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

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

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