B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Ultrasound-Guided Vacuum-Assisted Biopsy
2.2. Mammography-Guided Vacuum-Assisted Biopsy
2.3. Pathology after Needle Biopsy
2.4. Radiologic–Pathologic Correlation and Management
2.5. Surgical Excision, Surgical Pathology, and Follow-Up
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Type of Guidance | Number of VABs | Pathologic Category on VAB Samples | |||
---|---|---|---|---|---|
B2 | B3 | B4 | B5 | ||
Ultrasound | 2280 (62.7%) | 1403 (38.6%) | 246 (6.8%) | 7 (0.2%) | 624 (17.1%) |
Mammography | 1354 (37.3%) | 722 (19.9%) | 358 (9.8%) | 6 (0.2%) | 268 (7.4%) |
Total | 3634 (100.0%) | 2125 (58.5%) | 604 (16.6%) | 13 (0.4%) | 892 (24.5%) |
Lesion | Surgery | Outcome | Upgrade | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Type | Subtype | Total | Yes | No | Malignant | Benign | Negative at FU | Upgraded | Upgrade Rate (95% CI) | |
Invasive | DCIS | |||||||||
B3a | PL | 91 | 47 | 44 | 1 | 0 | 46 | 44 | 1 | 1.1% (0.2–6.0%) |
PT | 62 | 40 | 22 | 0 | 0 | 40 | 22 | 0 | 0.0% | |
RS-CSL | 79 | 25 | 54 | 0 | 0 | 25 | 54 | 0 | 0.0% | |
CCH | 24 | 2 | 22 | 0 | 0 | 2 | 22 | 0 | 0.0% | |
MLS | 6 | 1 | 5 | 0 | 0 | 1 | 5 | 0 | 0.0% | |
Subtotal B3a | 262 | 115 | 147 | 1 | 0 | 114 | 147 | 1 | 0.4% (0.1–2.1%) | |
B3b | ADH | 154 | 125 | 29 | 3 | 5 | 117 | 29 | 8 | 5.2% (2.7–9.9%) |
FEA | 123 | 62 | 61 | 0 | 3 | 59 | 61 | 3 | 2.4% (0.8–6.9%) | |
LIN1 | 40 | 28 | 12 | 0 | 1 | 27 | 12 | 1 | 2.5% (0.4–12.9%) | |
LIN2 | 25 | 25 | 0 | 3 | 1 | 21 | 0 | 4 | 16.0% (6.4–34.7%) | |
Subtotal B3b | 342 | 240 | 102 | 6 | 10 | 224 | 102 | 16 | 4.7% (2.9–7.5%) | |
Grand total | 604 | 355 | 249 | 7 | 10 | 338 | 249 | 17 | 2.8% (1.8–4.5%) |
Lesion | Surgery | Outcome | Upgrade | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Guidance | Type | Subtype | Total | Yes | No | Malignant | Benign | Negative at FU | Upgraded | Upgrade Rate (95% CI) | |
Invasive | DCIS | ||||||||||
US-guided | B3a | PL | 58 | 38 | 20 | 1 | 0 | 37 | 20 | 1 | 1.7% (0.3–9.1%) |
PT | 62 | 40 | 22 | 0 | 0 | 40 | 22 | 0 | 0.0% | ||
RS-CSL | 42 | 20 | 22 | 0 | 0 | 20 | 22 | 0 | 0.0% | ||
CCH | 9 | 2 | 7 | 0 | 0 | 2 | 7 | 0 | 0.0% | ||
MLS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0.0% | ||
Subtotal B3a | 171 | 100 | 71 | 1 | 0 | 99 | 71 | 1 | 0.6% (0.1–3.2%) | ||
B3b | ADH | 35 | 33 | 2 | 0 | 3 | 30 | 2 | 3 | 8.6% (3.0–22.4%) | |
FEA | 19 | 14 | 5 | 0 | 0 | 14 | 5 | 0 | 0.0% | ||
LIN1 | 15 | 10 | 5 | 0 | 1 | 9 | 5 | 1 | 6.7% (1.2–29.8%) | ||
LIN2 | 6 | 6 | 0 | 1 | 0 | 5 | 0 | 1 | 16.7% (3.0–56.4%) | ||
Subtotal B3b | 75 | 63 | 12 | 1 | 4 | 58 | 12 | 5 | 6.7% (2.9–14.7%) | ||
Total US | 246 | 163 | 83 | 2 | 4 | 157 | 83 | 6 | 2.4% (1.1–5.2%) | ||
MX-guided | B3a | PL | 33 | 9 | 24 | 0 | 0 | 9 | 24 | 0 | 0.0% |
PT | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0.0% | ||
RS-CSL | 37 | 5 | 32 | 0 | 0 | 5 | 32 | 0 | 0.0% | ||
CCH | 15 | 0 | 15 | 0 | 0 | 0 | 15 | 0 | 0.0% | ||
MLS | 6 | 1 | 5 | 0 | 0 | 1 | 5 | 0 | 0.0% | ||
Subtotal B3a | 91 | 15 | 76 | 0 | 0 | 15 | 76 | 0 | 0.0% | ||
B3b | ADH | 119 | 92 | 27 | 3 | 2 | 87 | 27 | 5 | 4.2% (1.8–9.5%) | |
FEA | 104 | 48 | 56 | 0 | 3 | 45 | 56 | 3 | 2.9% (1.0–8.1%) | ||
LIN1 | 25 | 18 | 7 | 0 | 0 | 18 | 7 | 0 | 0.0% | ||
LIN2 | 19 | 19 | 0 | 2 | 1 | 16 | 0 | 3 | 15.8% (5.5–37.6%) | ||
Subtotal B3b | 267 | 177 | 90 | 5 | 6 | 166 | 90 | 11 | 4.1% (2.3–7.2%) | ||
Total MX | 358 | 192 | 166 | 5 | 6 | 181 | 166 | 11 | 3.1% (1.7–5.4%) |
Lesion | Surgery | Outcome | Upgrade | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Needle Caliper | Type | Subtype | Total | Yes | No | Malignant | Benign | Negative at FU | Upgraded | Upgrade Rate (95% CI) | |
Invasive | DCIS | ||||||||||
7-gauge | B3a | PL | 14 | 3 | 11 | 0 | 0 | 3 | 11 | 0 | 0% |
PT | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0% | ||
RS-CSL | 9 | 2 | 7 | 0 | 0 | 2 | 7 | 0 | 0% | ||
CCH | 6 | 0 | 6 | 0 | 0 | 0 | 6 | 0 | 0% | ||
MLS | 3 | 0 | 3 | 0 | 0 | 0 | 3 | 0 | 0% | ||
Subtotal B3a | 32 | 5 | 27 | 0 | 0 | 5 | 27 | 0 | 0% | ||
B3b | ADH | 44 | 33 | 11 | 1 | 0 | 32 | 11 | 1 | 2.3% (0.4–11.8%) | |
FEA | 36 | 19 | 17 | 0 | 2 | 17 | 17 | 2 | 5.6% (1.5–18.1%) | ||
LIN1 | 13 | 7 | 6 | 0 | 0 | 7 | 6 | 0 | 0% | ||
LIN2 | 8 | 8 | 0 | 0 | 1 | 7 | 0 | 1 | 12.5% (2.2–47.1%) | ||
Subtotal B3b | 101 | 67 | 34 | 1 | 3 | 63 | 34 | 4 | 4.0% (1.6–9.7%) | ||
Total 7-gauge | 133 | 72 | 61 | 1 | 3 | 68 | 61 | 4 | 3.0% (1.2–7.5%) | ||
10-gauge | B3a | PL | 19 | 6 | 13 | 0 | 0 | 6 | 13 | 0 | 0% |
PT | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0% | ||
RS-CSL | 28 | 3 | 25 | 0 | 0 | 3 | 25 | 0 | 0% | ||
CCH | 9 | 0 | 9 | 0 | 0 | 0 | 9 | 0 | 0% | ||
MLS | 3 | 1 | 2 | 0 | 0 | 1 | 2 | 0 | 0% | ||
Subtotal B3a | 59 | 10 | 49 | 0 | 0 | 10 | 49 | 0 | 0% | ||
B3b | ADH | 75 | 59 | 16 | 2 | 2 | 55 | 16 | 4 | 5.3% (2.1–12.9%) | |
FEA | 68 | 29 | 39 | 0 | 1 | 28 | 39 | 1 | 1.5% (0.3–7.9%) | ||
LIN1 | 12 | 11 | 1 | 0 | 0 | 11 | 1 | 0 | 0% | ||
LIN2 | 11 | 11 | 0 | 2 | 0 | 9 | 0 | 2 | 18.2% (5.1–47.7%) | ||
Subtotal B3b | 166 | 110 | 56 | 4 | 3 | 103 | 56 | 7 | 4.2% (2.1–8.4%) | ||
Total 10-gauge | 225 | 120 | 105 | 4 | 3 | 113 | 105 | 7 | 3.1% (1.5–6.3%) |
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Girardi, V.; Guaragni, M.; Ruzzenenti, N.; Palmieri, F.; Fogazzi, G.; Cozzi, A.; Lucchini, D.; Buffoli, A.; Schiaffino, S.; Sardanelli, F. B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies. Cancers 2021, 13, 5443. https://doi.org/10.3390/cancers13215443
Girardi V, Guaragni M, Ruzzenenti N, Palmieri F, Fogazzi G, Cozzi A, Lucchini D, Buffoli A, Schiaffino S, Sardanelli F. B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies. Cancers. 2021; 13(21):5443. https://doi.org/10.3390/cancers13215443
Chicago/Turabian StyleGirardi, Veronica, Monica Guaragni, Nella Ruzzenenti, Fabrizio Palmieri, Gianluca Fogazzi, Andrea Cozzi, Diana Lucchini, Alberto Buffoli, Simone Schiaffino, and Francesco Sardanelli. 2021. "B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies" Cancers 13, no. 21: 5443. https://doi.org/10.3390/cancers13215443