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Fourteen‐gauge needle core biopsy of mammographically evident radial scars
Author(s) -
Cawson Jennifer N.,
Malara Frank,
Kavanagh Anne,
Hill Prue,
Balasubramanium Gnani,
Henderson Michael
Publication year - 2003
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.11070
Subject(s) - medicine , biopsy , scars , ductal carcinoma , surgery , radiology , breast cancer , cancer
BACKGROUND Radial scars are benign lesions that may mimic breast carcinoma on mammography and usually are managed by excision biopsy. The authors report their experience with stereotactic needle core biopsy (SNCB) in sampling these lesions. METHODS A prospective study examined a consecutive series of 75 mammographically detected radial scars from a population‐based screening program. In patients who were sampled by SNCB followed by surgical biopsy, the histologic findings of core biopsy and the gold standard of excision biopsy were compared. RESULTS Sixty‐three patients were sampled by core biopsy: SNCB was used in 55 patients (87.0%), and ultrasound‐guided needle core biopsy (UNCB) was used in 8 patients (13%). One patient who underwent SNCB did not undergo a follow‐up excision biopsy. Radial scars were diagnosed preoperatively by core biopsy in 51 of 62 patients who underwent excision (82%; 95% confidence interval [95%CI], 70–91%). The sensitivity for SNCB was 85% (95%CI, 73–94%), and the sensitivity for UNCB was 63% (95%CI, 24–91%). Of 54 patients who underwent SNCB and excision, 4 patients had coexistent ductal carcinoma in situ (DCIS) at the time they underwent surgical excision: SNCB identified DCIS in 1 patient and identified atypical ductal hyperplasia (ADH) in 3 patients. In the entire group of 75 radial scars, 5 scars were associated with DCIS (7%), and there were no invasive carcinomas. ADH was present in association with 42 of 74 radial scars that were excised surgically (57%). Twenty‐nine of those radial scars were sampled preoperatively by SNCB. ADH was found in 21 patients (72%; 95CI, 53–87%). CONCLUSIONS The sensitivity of SNCB in the identification of radial scars was 85%. In four patients with associated DCIS, SNCB revealed either ADH or DCIS, both of which required excision. These findings suggest that patients with SNCB‐proven radial scars among a screened population can be managed safely by mammographic follow‐up, provided there is no associated DCIS, ADH, or lobular carcinoma in situ. Spiculated abnormalities with discordant SNCB results require surgical biopsy. Cancer 2003;97:345–51. © 2003 American Cancer Society. DOI 10.1002/cncr.11070