Borderline breast lesions: comparison of malignancy underestimation rates with 14-gauge core needle biopsy versus 11-gauge vacuum-assisted device
Borderline breast lesions: comparison of malignancy underestimation rates with 14-gauge core needle biopsy versus 11-gauge vacuum-assisted device
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DOI：
10.1007/s00330-010-2053-7
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发表时间：
2011-06-01
影响因子：
5.9
通讯作者：
Bazzocchi, Massimo
中科院分区：
文献类型：
--
作者：
Londero, Viviana;Zuiani, Chiara;Bazzocchi, Massimo
比较14 g芯针活检（CNB）和11 g真空辅助活检（VAB）经皮诊断边缘性乳腺病变（B3）的恶性肿瘤低估率。回顾性审查了4764例图像引导乳腺活检的组织学结果。300例B3、151例良性乳头状瘤、88例放射状硬化性病变、46例小叶瘤变、15例非典型导管增生在超声引导下14-g CNB（76%）或立体定向引导下11-g VAB（24%）诊断。平均而言，用CNB获得5个核心，用VAB获得12个核心。活检变量进行了审查，并与手术切除或随访（> 24个月）。对237个病变进行了手术切除：178个为良性，21个为非典型，38个为癌症。其余63处病变在随访时无变化。14 g CNB组和11 g VAB组的总体恶性肿瘤低估率分别为12.7%和12.5%。根据切除组织学或随访，病变特异性低估率为：良性乳头状瘤：14-g CNB 11%，11-g VAB 0%; RSL：14-g CNB 6%，11-g VAB 4%; LN：14-g CNB 40%，11-g VAB 23%; ADH：14-g CNB 33%; 11-g VAB 22%。在经皮诊断B3病变的情况下，无论活检方法如何，恶性肿瘤的估计都会被低估。
To compare malignancy underestimation rates in the case of percutaneous diagnosis of borderline breast lesions(B3) at 14-g core-needle-biopsy (CNB) and at 11-g vacuum-assisted-biopsy (VAB).The histological results of 4764 image-guided breast biopsies were retrospectively reviewed. 300 B3, 151 benign papillomas, 88 radial sclerosing lesions, 46 lobular neoplasia, 15 atypical ductal hyperplasia diagnosed at ultrasound-guided 14-g CNB (76%) or stereotactically-guided 11-g VAB (24%) were identified. On average, 5 cores were obtained with CNB and 12 with VAB. Biopsy variables were reviewed and correlated with surgical excision or follow-up (> 24 months). Lesion- and device-specific underestimation rates of malignancy were calculated.Surgical excision was performed on 237 lesions: 178 were benign, 21 atypical, 38 cancers. The remaining 63 lesions were unchanged at follow-up. Overall malignancy underestimation rate was 12.7% at 14-g CNB and 12.5% at 11-g VAB. Based on excision histology or follow-up, lesion-specific underestimation rates were: benign papillomas: 14-g CNB 11%, 11-g VAB 0%; RSL: 14-g CNB 6%, 11-g VAB 4%; LN: 14-g CNB 40%, 11-g VAB 23%; ADH: 14-g CNB 33%; 11-g VAB 22%.In the case of percutaneous diagnosis of B3 lesions, underestimation of malignancy occurs regardless of the biopsy method.