Underestimation of DCIS at MRI-guided vacuum-assisted breast biopsy. Academic Article uri icon

Overview

MeSH

  • Adult
  • Aged
  • Chi-Square Distribution
  • False Negative Reactions
  • Female
  • Humans
  • Magnetic Resonance Imaging, Interventional
  • Middle Aged
  • Retrospective Studies
  • Vacuum

MeSH Major

  • Biopsy
  • Breast Neoplasms
  • Carcinoma in Situ
  • Carcinoma, Ductal, Breast

abstract

  • The study objective was to assess the rate of underestimation of ductal carcinoma in situ (DCIS) at MRI-guided 9-gauge vacuum-assisted breast biopsy. An institutional review board-approved retrospective review was performed of 373 consecutive lesions that had undergone MRI vacuum-assisted breast biopsy. In 34 lesions with subsequent surgery, vacuum-assisted breast biopsy yielded DCIS without frank microinvasion or invasion. DCIS underestimates were lesions for which vacuum-assisted breast biopsy yielded DCIS without frank microinvasion or invasion at biopsy and surgery yielded invasive cancer. Records and pathology findings were reviewed. Among 34 lesions, vacuum-assisted breast biopsy histology was DCIS in 29 and DCIS with possible microinvasion in five. Of 29 lesions yielding DCIS at MRI vacuum-assisted breast biopsy, surgical excision revealed invasive cancer in five (17%; 95% CI, 6-36%). The DCIS underestimation rate was significantly higher in lesions 6 cm or larger versus smaller lesions (60% vs 8%, p = 0.02). MRI lesion type, kinetics, number of specimens, menopausal status, and target sampling versus excision did not significantly affect underestimation. Of five lesions yielding DCIS with possible microinvasion at MRI vacuum-assisted breast biopsy, surgery revealed invasive carcinoma in four (80%; 95% CI, 28-99%). DCIS underestimation was significantly more likely if MRI vacuum-assisted breast biopsy showed possible microinvasion than if it did not (80% vs 17%, p =0.01). Underestimation occurred in 17% of lesions yielding DCIS and in 80% of lesions yielding DCIS with possible microinvasion at MRI vacuum-assisted breast biopsy. DCIS underestimation was significantly more likely in lesions measuring 6 cm or larger. No other patient or lesion factors significantly affected DCIS underestimation at MRI vacuum-assisted breast biopsy.

publication date

  • August 2007

has subject area

  • Adult
  • Aged
  • Biopsy
  • Breast Neoplasms
  • Carcinoma in Situ
  • Carcinoma, Ductal, Breast
  • Chi-Square Distribution
  • False Negative Reactions
  • Female
  • Humans
  • Magnetic Resonance Imaging, Interventional
  • Middle Aged
  • Retrospective Studies
  • Vacuum

Research

keywords

  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.2214/AJR.07.2172

PubMed ID

  • 17646475

Additional Document Info

start page

  • 468

end page

  • 474

volume

  • 189

number

  • 2