Stereotactic breast biopsy: comparison of histologic underestimation rates with 11- and 9-gauge vacuum-assisted breast biopsy.
Author(s): Lourenco AP, Mainiero MB, Lazarus E, Giri D, Schepps B
Publication: AJR Am J Roentgenol, 2007, Vol. 189, Page W275-9
PubMed ID: 17954625 PubMed Review Paper? No
Purpose of Paper
This paper compared the characteristics and underestimation rate of stereotactic vacuum-assisted breast biopsies obtained with 11- and 9-gauge needles.
Conclusion of Paper
The 11-gauge and 9-gauge biopsies had comparable rates of clusters of calcification. A comparable percentage of cases biopsied with the two needle types were upgraded from atypical ductal hyperplasia (ADH) to ductal carcinoma in situ (DCIS) or invasive carcinoma after surgical resection (28.3% and 29.6%, respectively) and from DCIS to invasive carcinoma after surgical resection (28.7% and 22.7%, respectively). In cases of DCIS, the rate of underestimation as ADH increased with increasing lesion size (odds ratio=1.039, P=0.03).
Studies
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Study Purpose
This study compared the characteristics and underestimation rate of stereotactic vacuum-assisted breast biopsies obtained with 11- and 9-gauge needles. Results from stereotactic vacuum-assisted breast biopsies obtained with an 11-gauge needle in 828 cases and with a 9-gauge needle in 395 cases were compared with those obtained by surgical resection (239 cases). All lesions were BI-RADS category 4 or 5 and lesion size was comparable between groups. It is assumed that the pathological analysis included light microscopy and H&E staining of formalin-fixed paraffin-embedded sections.
Summary of Findings:
The 11-gauge and 9-gauge biopsies had comparable rates of clusters of calcification (82% and 87%, respectively) and non-calcified lesions including masses, architectural distortion, and asymmetries (18% and 13%, respectively). Slightly, but not significantly, more specimens per lesion were obtained with an 11-gauge needle (mean of 8 specimens, range 6-24) than with a 9-gauge needle (mean of 7 specimens, range 1-20). Comparable percentages of specimens diagnosed as ADH based on biopsy with an 11- or 9-gauge needle were found to contain DCIS or invasive carcinoma after surgical resection (28.3% and 29.6%, respectively P=0.9). Similarly, surgical specimens from cases diagnosed as DCIS in the biopsy were found to contain invasive carcinoma in 28.7% of cases (35 of 122) biopsied with an 11- gauge needle and 22.7% of cases (10 of 44) biopsied with a 9-gauge needle (P=0.4). Interestingly, in cases of DCIS the rate of underestimation as ADH increased with increasing lesion size (odds ratio=1.039, P=0.03).
Biospecimens
Preservative Types
- Formalin
Diagnoses:
- Neoplastic - Benign
- Neoplastic - Carcinoma
Platform:
Analyte Technology Platform Morphology H-and-E microscopy Morphology Light microscopy Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Method of tissue acquisition Vacuum assisted biopsy
Surgical resection
Biospecimen Acquisition Needle gauge 11-gauge
9-gauge