Contemporary indications for diagnostic open biopsy in women assessed for screen-detected breast lesions: A ten-year, single institution series of 814 consecutive cases

被引:9
作者
Farshid, Gelareh [1 ,2 ]
Gill, P. Grantley [3 ,4 ]
机构
[1] Univ Adelaide, Discipline Med, BreastScreen SA, 167 Flinders St, Adelaide, SA 5000, Australia
[2] SA Pathol, Directorate Surg Pathol, 167 Flinders St, Adelaide, SA 5000, Australia
[3] BreastScreen SA, Adelaide, SA, Australia
[4] Univ Adelaide, Dept Surg, Adelaide, SA, Australia
关键词
Breast cancer; Screening; Mammography; Core biopsy; NEEDLE CORE BIOPSY; ATYPICAL DUCTAL HYPERPLASIA; MALIGNANT POTENTIAL B3; IN-SITU NEOPLASIA; SURGICAL EXCISION; EPITHELIAL ATYPIA; MANAGEMENT; PERFORMANCE; EXPERIENCE; CANCER;
D O I
10.1007/s10549-016-4087-2
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
In contemporary practice, 5% of women with non-malignant needle biopsies of screen-detected lesions still require diagnostic open biopsy (OBx). Our aims are to (i) capture a snapshot of the contemporary indications for OBx in screen-detected lesions; (ii) determine upgrade rates to malignancy (DCIS or invasive cancer); (iii) identify indications with sufficiently low upgrades to justify avoidance of OBx and (iv) propose plausible non-surgical alternatives. Between Jan 2005 and Dec 2014, women assessed for a screen-detected lesion and recommended for OBx are included. We retrieved patient, imaging, biopsy and final pathology or follow-up data. 814 lesions, mean diameter 16.7 mm, microcalcifications in 353 (43.4%) cases, lesions other than calcifications in 461 (56.6%), mean patient age 58.4 yrs, are included. Surgery was performed in 98.2% cases. Imaging follow-up (1-6.5 yrs) is available in 13 of 15 remaining cases. 27 indications for OBx were identified, with a prevalence of 0.3-13.9%. Borderline lesions (BL) comprised 64% of OBx indications, amongst which atypical ductal hyperplasia was the most prevalent at 13.9%, followed by papillary lesions, radial scars, flat epithelial atypia and lobular neoplasia. Imaging factors contributed 26.3% of OBx. In 9.8% of cases, NCB was not performed due to client, technical or cytologic factors. Overall, 261(32.1%) lesions were malignant at OBx. Upgrade rates varied from 0 to 100%, depending on the specific indication for OBx. Surgical biopsy remains a valuable method of last resort for breast cancer diagnosis but strategies to limit benign breast surgery merit attention as a public health issue.
引用
收藏
页码:49 / 58
页数:10
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