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

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