High risk breast lesions identified on MrI-guided vacuum-assisted needle biopsy: Outcome of surgical excision and imaging follow-up

Megan E. Speer, Monica L. Huang, Basak E. Dogan, Beatriz E. Adrada, Rosalind P. Candelaria, Kenneth R. Hess, Palita Hansakul, Wei T. Yang, Gaiane M. Rauch

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To determine whether breast MRI-guided vacuum-assisted biopsy (MRI-VAB) high-risk lesion histology influences surgical or long-term imaging follow-up outcomes. Methods: Patients with imaging-concordant high-risk findings on 9-gauge breast MRI-VAB between January 2007 and July 2012 who had surgical histopathology or 2 year imaging follow-up were retrospectively reviewed. results: 90 patients with 99 lesions were included. Lesions were atypical ductal hyperplasia (ADH) (n = 21), lobular neoplasia [n = 36; atypical lobular hyperplasia (ALH) (n = 22), lobular carcinoma in situ (LCIS) (n = 6), and ALH plus LCIS (n = 8)], and other high-risk lesion (n = 42; papillary lesions, radial scar, flat epithelial atypia, atypia unspecified). Of 53 excised lesions, 6 (11%) were upgraded to invasive cancer or ductal carcinoma in situ (DCIS). 4 of 21 (19%) ADH lesions were upgraded to DCIS. 2 of 36 (6%) lobular neoplasia lesions, both combined ALH and LCIS, were upgraded to DCIS, and invasive lobular carcinoma, respectively. The remaining 46 lesions were managed conservatively with imaging follow-up: 17 (37%) had mammography only, while 29 (63%) had mammography and MRI follow-up. There was no evidence of breast cancer development at the site of MRI-VAB in the cases with only imaging follow-up. conclusion: We conclude that the upgrade rate for high-risk lesions at MRI-VAB at surgical excision is low. Surgical excision is warranted for ADH and combined ALH-LCIS lesions. For other lesions, a multidisciplinary approach to decide on personalized management may be appropriate. advances in knowledge: Surgical excision is warranted for ADH lesions and combined ALH-LCIS lesions identified at breast MRI-VAB. A multidisciplinary approach to patient management of other high-risk lesions may be appropriate.

Original languageEnglish (US)
Article number20180300
JournalBritish Journal of Radiology
Volume91
Issue number1090
DOIs
StatePublished - Jan 1 2018

Fingerprint

Carcinoma, Intraductal, Noninfiltrating
Needle Biopsy
Vacuum
Breast
Hyperplasia
Biopsy
Mammography
Lobular Carcinoma
Neoplasms
Cicatrix
Histology
Breast Carcinoma In Situ
Breast Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

High risk breast lesions identified on MrI-guided vacuum-assisted needle biopsy : Outcome of surgical excision and imaging follow-up. / Speer, Megan E.; Huang, Monica L.; Dogan, Basak E.; Adrada, Beatriz E.; Candelaria, Rosalind P.; Hess, Kenneth R.; Hansakul, Palita; Yang, Wei T.; Rauch, Gaiane M.

In: British Journal of Radiology, Vol. 91, No. 1090, 20180300, 01.01.2018.

Research output: Contribution to journalArticle

Speer, Megan E. ; Huang, Monica L. ; Dogan, Basak E. ; Adrada, Beatriz E. ; Candelaria, Rosalind P. ; Hess, Kenneth R. ; Hansakul, Palita ; Yang, Wei T. ; Rauch, Gaiane M. / High risk breast lesions identified on MrI-guided vacuum-assisted needle biopsy : Outcome of surgical excision and imaging follow-up. In: British Journal of Radiology. 2018 ; Vol. 91, No. 1090.
@article{bcb8865286aa43cd81f9c85026c4b83d,
title = "High risk breast lesions identified on MrI-guided vacuum-assisted needle biopsy: Outcome of surgical excision and imaging follow-up",
abstract = "Objective: To determine whether breast MRI-guided vacuum-assisted biopsy (MRI-VAB) high-risk lesion histology influences surgical or long-term imaging follow-up outcomes. Methods: Patients with imaging-concordant high-risk findings on 9-gauge breast MRI-VAB between January 2007 and July 2012 who had surgical histopathology or 2 year imaging follow-up were retrospectively reviewed. results: 90 patients with 99 lesions were included. Lesions were atypical ductal hyperplasia (ADH) (n = 21), lobular neoplasia [n = 36; atypical lobular hyperplasia (ALH) (n = 22), lobular carcinoma in situ (LCIS) (n = 6), and ALH plus LCIS (n = 8)], and other high-risk lesion (n = 42; papillary lesions, radial scar, flat epithelial atypia, atypia unspecified). Of 53 excised lesions, 6 (11{\%}) were upgraded to invasive cancer or ductal carcinoma in situ (DCIS). 4 of 21 (19{\%}) ADH lesions were upgraded to DCIS. 2 of 36 (6{\%}) lobular neoplasia lesions, both combined ALH and LCIS, were upgraded to DCIS, and invasive lobular carcinoma, respectively. The remaining 46 lesions were managed conservatively with imaging follow-up: 17 (37{\%}) had mammography only, while 29 (63{\%}) had mammography and MRI follow-up. There was no evidence of breast cancer development at the site of MRI-VAB in the cases with only imaging follow-up. conclusion: We conclude that the upgrade rate for high-risk lesions at MRI-VAB at surgical excision is low. Surgical excision is warranted for ADH and combined ALH-LCIS lesions. For other lesions, a multidisciplinary approach to decide on personalized management may be appropriate. advances in knowledge: Surgical excision is warranted for ADH lesions and combined ALH-LCIS lesions identified at breast MRI-VAB. A multidisciplinary approach to patient management of other high-risk lesions may be appropriate.",
author = "Speer, {Megan E.} and Huang, {Monica L.} and Dogan, {Basak E.} and Adrada, {Beatriz E.} and Candelaria, {Rosalind P.} and Hess, {Kenneth R.} and Palita Hansakul and Yang, {Wei T.} and Rauch, {Gaiane M.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1259/bjr.20180300",
language = "English (US)",
volume = "91",
journal = "British Journal of Radiology",
issn = "0007-1285",
publisher = "British Institute of Radiology",
number = "1090",

}

TY - JOUR

T1 - High risk breast lesions identified on MrI-guided vacuum-assisted needle biopsy

T2 - Outcome of surgical excision and imaging follow-up

AU - Speer, Megan E.

AU - Huang, Monica L.

AU - Dogan, Basak E.

AU - Adrada, Beatriz E.

AU - Candelaria, Rosalind P.

AU - Hess, Kenneth R.

AU - Hansakul, Palita

AU - Yang, Wei T.

AU - Rauch, Gaiane M.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: To determine whether breast MRI-guided vacuum-assisted biopsy (MRI-VAB) high-risk lesion histology influences surgical or long-term imaging follow-up outcomes. Methods: Patients with imaging-concordant high-risk findings on 9-gauge breast MRI-VAB between January 2007 and July 2012 who had surgical histopathology or 2 year imaging follow-up were retrospectively reviewed. results: 90 patients with 99 lesions were included. Lesions were atypical ductal hyperplasia (ADH) (n = 21), lobular neoplasia [n = 36; atypical lobular hyperplasia (ALH) (n = 22), lobular carcinoma in situ (LCIS) (n = 6), and ALH plus LCIS (n = 8)], and other high-risk lesion (n = 42; papillary lesions, radial scar, flat epithelial atypia, atypia unspecified). Of 53 excised lesions, 6 (11%) were upgraded to invasive cancer or ductal carcinoma in situ (DCIS). 4 of 21 (19%) ADH lesions were upgraded to DCIS. 2 of 36 (6%) lobular neoplasia lesions, both combined ALH and LCIS, were upgraded to DCIS, and invasive lobular carcinoma, respectively. The remaining 46 lesions were managed conservatively with imaging follow-up: 17 (37%) had mammography only, while 29 (63%) had mammography and MRI follow-up. There was no evidence of breast cancer development at the site of MRI-VAB in the cases with only imaging follow-up. conclusion: We conclude that the upgrade rate for high-risk lesions at MRI-VAB at surgical excision is low. Surgical excision is warranted for ADH and combined ALH-LCIS lesions. For other lesions, a multidisciplinary approach to decide on personalized management may be appropriate. advances in knowledge: Surgical excision is warranted for ADH lesions and combined ALH-LCIS lesions identified at breast MRI-VAB. A multidisciplinary approach to patient management of other high-risk lesions may be appropriate.

AB - Objective: To determine whether breast MRI-guided vacuum-assisted biopsy (MRI-VAB) high-risk lesion histology influences surgical or long-term imaging follow-up outcomes. Methods: Patients with imaging-concordant high-risk findings on 9-gauge breast MRI-VAB between January 2007 and July 2012 who had surgical histopathology or 2 year imaging follow-up were retrospectively reviewed. results: 90 patients with 99 lesions were included. Lesions were atypical ductal hyperplasia (ADH) (n = 21), lobular neoplasia [n = 36; atypical lobular hyperplasia (ALH) (n = 22), lobular carcinoma in situ (LCIS) (n = 6), and ALH plus LCIS (n = 8)], and other high-risk lesion (n = 42; papillary lesions, radial scar, flat epithelial atypia, atypia unspecified). Of 53 excised lesions, 6 (11%) were upgraded to invasive cancer or ductal carcinoma in situ (DCIS). 4 of 21 (19%) ADH lesions were upgraded to DCIS. 2 of 36 (6%) lobular neoplasia lesions, both combined ALH and LCIS, were upgraded to DCIS, and invasive lobular carcinoma, respectively. The remaining 46 lesions were managed conservatively with imaging follow-up: 17 (37%) had mammography only, while 29 (63%) had mammography and MRI follow-up. There was no evidence of breast cancer development at the site of MRI-VAB in the cases with only imaging follow-up. conclusion: We conclude that the upgrade rate for high-risk lesions at MRI-VAB at surgical excision is low. Surgical excision is warranted for ADH and combined ALH-LCIS lesions. For other lesions, a multidisciplinary approach to decide on personalized management may be appropriate. advances in knowledge: Surgical excision is warranted for ADH lesions and combined ALH-LCIS lesions identified at breast MRI-VAB. A multidisciplinary approach to patient management of other high-risk lesions may be appropriate.

UR - http://www.scopus.com/inward/record.url?scp=85054454626&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054454626&partnerID=8YFLogxK

U2 - 10.1259/bjr.20180300

DO - 10.1259/bjr.20180300

M3 - Article

C2 - 29947265

AN - SCOPUS:85054454626

VL - 91

JO - British Journal of Radiology

JF - British Journal of Radiology

SN - 0007-1285

IS - 1090

M1 - 20180300

ER -