A diagnostic strategy for breast calcifications based on a long-term follow-up of 615 lesions
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To clarify the long-term outcomes of breast calcifications after stereotactic vacuum-assisted breast biopsy (SVAB) and to develop strategy after SVAB.
Subject comprised 594 patients with 615 calcifications who underwent SVAB. 371 (60.3%) lesions were diagnosed as benign, 38 (6.2%) as indeterminate, and 206 (33.5%) as malignant. We retrospectively reviewed post-biopsy courses of non-malignant lesions which were followed. A histopathological review was performed for false negatives to clarify the reasons.
Of the 308 patients with benign lesions, with a median follow-up time of 55.8 months, re-biopsy was performed for 11 (3.6%) due to changes of imaging, and 4 (1.3%) were diagnosed as breast cancer. Of the 36 patients with indeterminate lesion, re-biopsy was performed for 16 (44.4%), and 8 (22.2%) were diagnosed as breast cancer, while 20 (55.6%) showed no changes in imaging with a median follow-up time of 91.7 months without re-biopsy. Weak atypism of intraductal carcinoma may cause a false-negative diagnosis in SVAB for breast calcifications.
When SVAB results in non-malignant, patients may be followed by annual screening, while re-biopsy needs to be performed for the patients with a discordant result of SVAB and with changes in an imaging finding during a follow-up.
KeywordsBreast cancer Calcifications Mammography Stereotactic vacuum-assisted breast biopsy
Compliance with ethical standards
Informed consent was obtained from all individual participants included in the study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Ellis IO, Humphreys S, Michell M, Pinder SE, Wells CA, Zakhour HD, UK National Coordinating Commmittee for Breast Screening Pathology; European Commission Working Group on Breast Screening Pathology. Best Practice No 179. Guidelines for breast needle core biopsy handling and reporting in breast screening assessment. J Clin Pathol. 2004;57:897–902. https://doi.org/10.1136/jcp.2003.010983.CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Johnson JM, Johnson AK, O’Meara ES, Miglioretti DL, Geller BM, Hotaling EN, et al. Breast cancer detection with short-interval follow-up compared with return to annual screening in patients with benign stereotactic or US-guided breast biopsy results. Radiology. 2015;275:54–60. https://doi.org/10.1148/radiol.14140036.CrossRefPubMedGoogle Scholar
- 5.Atasoy NM, Tasali N, Çubuk R, Narin B, Deveci U, Yener N, et al. Vacuum-assisted stereotactic biopsy for isolated BI-RADS 4 microcalcifications: evaluation with histopathology and midterm follow-up results. Diagn Interv Radiol. 2015;21:22–7. https://doi.org/10.5152/dir.2014.14139.CrossRefPubMedGoogle Scholar
- 6.Rageth CJ, O’Flynn EA, Comstock C, Kurtz C, Kubik R, Madjar H, et al. First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Breast Cancer Res Treat. 2016;159:203–13. https://doi.org/10.1007/s10549-016-3935-4.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Corsetti V, Houssami N, Ferrari A, Ghirardi M, Bellarosa S, Angelini O, et al. Breast screening with ultrasound in women with mammography-negative dense breasts: evidence on incremental cancer detection and false positives, and associated cost. Eur J Cancer. 2008;44:539–44. https://doi.org/10.1016/j.ejca.2008.01.009.CrossRefPubMedGoogle Scholar