Rates of Presurgical Underestimation of Breast Cancer after Standardized Assessment of Breast Calcifications.

Timpe L, Berkemeyer S, Puesken M, Tio J, Heindel W, Weigel S

Forschungsartikel (Zeitschrift) | Peer reviewed

Zusammenfassung

Purpose: To determine the frequency of histopathological underestimation of breast cancer after vacuum-assisted biopsy (VAB) in standardized assessment of breast calcifications compared to postsurgical diagnosis. Materials and Methods: The retrospective study included acquired data of 506 consecutively examined women, who underwent VAB for the assessment of pure calcifications after standardized digital mammographic and sonographic imaging. 119/506 (24.5 %) women underwent further surgical procedures: 37 women had a surgical diagnostic excision biopsy, 82 women a surgical procedure based on a therapeutic concept. Presurgical results of VAB were compared with the postsurgical histopathological reports. Results: In 91/119 women (76.5 %) the final histology was malignant. The rate of ductal carcinoma in situ (DCIS) was 79.1 % (72/91) and the rate of invasive carcinoma was 20.9 % (19/91). In 9/37 women with diagnostic excision biopsy, the presurgical status of benign or uncertain changed to a postsurgical diagnosis of malignant (24.3 %). In eight cases underestimation included DCIS (21.6 %) and in one case invasive cancer (2.7 %). Seven of the nine underestimated cases (77.8 %) resulted from excision biopsy of atypical epithelial proliferation of ductal type (AEPDT, positive predictive value 30.4 % (7/23)). After surgery due to DCIS in 7/71 women invasive breast cancer was diagnosed (9.9 %). In 11/82 women with oncological surgery, invasive cancer was already diagnosed by VAB. Conclusion: Underestimation of invasive cancer in terms of presurgical DCIS diagnosis can be minimized by the standardized assessment protocol to about 10 %. Underestimation of DCIS is mainly related to presurgical diagnosis of AEPDT. Key Points: o?The standardized use of digital mammographic and sonographic imaging prior to vacuum-assisted biopsy is suitable for minimizing underestimation of invasive breast cancer. AEPDT represents a high risk diagnosis for underestimation of DCIS. Citation Format: o?Timpe L., Berkemeyer S., Puesken M. et al. Rates of Presurgical Underestimation of Breast Cancer after Standardized Assessment of Breast Calcifications. Fortschr Röntgenstr 2015; 187: 445 - 449.

Details zur Publikation

FachzeitschriftFortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin (RöFo)
Jahrgang / Bandnr. / Volume187
Ausgabe / Heftnr. / Issue6
Seitenbereich445-449
StatusVeröffentlicht
Veröffentlichungsjahr2015
Sprache, in der die Publikation verfasst istEnglisch
Link zum VolltextPM:25877994; ISI:000355425100006
StichwörterDIGITAL MAMMOGRAPHY; ultrasound; breast; LESIONS; MRI; vacuum-assisted; biopsy breast; LYMPH-NODE BIOPSY; biopsy; breast cancer; quality assurance; CARCINOMA IN-SITU

Autor*innen der Universität Münster

Tio, Joke
Klinik für Frauenheilkunde und Geburtshilfe