Advertisement

A diagnostic strategy for breast calcifications based on a long-term follow-up of 615 lesions

  • Rika YonekuraEmail author
  • Rie Horii
  • Takuji Iwase
  • Naoya Gomi
  • Masanobu Kitagawa
  • Futoshi Akiyama
  • Shinji Ohno
Original Article
  • 24 Downloads

Abstract

Purpose

To clarify the long-term outcomes of breast calcifications after stereotactic vacuum-assisted breast biopsy (SVAB) and to develop strategy after SVAB.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Breast cancer Calcifications Mammography Stereotactic vacuum-assisted breast biopsy 

Notes

Compliance with ethical standards

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

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.

References

  1. 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
  2. 2.
    Heywang-Köbrunner SH, Schreer I, Decker T, Böcker W. Interdisciplinary consensus on the use and technique of vacuum assisted stereotactic breast biopsy. Eur J Radiol. 2003;47:232–6.CrossRefGoogle Scholar
  3. 3.
    Salkowski LR, Fowler AM, Burnside ES, Sisney GA. Utility of 6-month follow-up imaging after a concordant benign breast biopsy result. Radiology. 2011;258:380–7.  https://doi.org/10.1148/radiol.10091824.CrossRefPubMedGoogle Scholar
  4. 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. 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. 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
  7. 7.
    Pfarl G, Helbich TH, Riedl CC, Wagner T, Gnant M, Rudas M, et al. Stereotactic 11-gauge vacuum-assisted breast biopsy: a validation study. AJR Am J Roentgenol. 2002;179:1503–7.  https://doi.org/10.2214/ajr.179.6.1791503.CrossRefPubMedGoogle Scholar
  8. 8.
    Ames V, Britton PD. Stereotactically guided breast biopsy: a review. Insights Imaging. 2011;2:171–6.  https://doi.org/10.1007/s13244-010-0064-1.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Elston CW, Sloane JP, Amendoeira I, Apostolikas N, Bellocq JP, Bianchi S, et al. Causes of inconsistency in diagnosing and classifying intraductal proliferations of the breast. European Commission Working Group on Breast Screening Pathology. Eur J Cancer. 2000;36:1769–72.CrossRefGoogle Scholar
  10. 10.
    Morris EA, Liberman L, Trevisan SG, Abramson AF, Dershaw D. Histologic heterogeneity of masses at percutaneous breast biopsy. Breast J. 2002;8:187–91.CrossRefGoogle Scholar
  11. 11.
    Jackman RJ, Marzoni FA, Rosenberg J. False-negative diagnoses at stereotactic vacuum-assisted needle breast biopsy: long-term follow-up of 1,280 lesions and review of the literature. AJR Am J Roentgenol. 2009;192:341–51.  https://doi.org/10.2214/AJR.08.1127.CrossRefPubMedGoogle Scholar
  12. 12.
    Horii R, Akiyama F, Kasumi F, Koike M, Sakamoto G. Spontaneous, “ healing” of breast cancer. Breast Cancer. 2005;12:140–4.CrossRefGoogle Scholar
  13. 13.
    Berg WA. Supplemental screening sonography in dense breasts. Radiol Clin N Am. 2004;42:845–51.  https://doi.org/10.1016/j.rcl.2004.04.003.CrossRefPubMedGoogle Scholar
  14. 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

Copyright information

© Japan Radiological Society 2018

Authors and Affiliations

  • Rika Yonekura
    • 1
    • 2
    • 3
    Email author
  • Rie Horii
    • 2
    • 4
  • Takuji Iwase
    • 1
  • Naoya Gomi
    • 5
  • Masanobu Kitagawa
    • 3
  • Futoshi Akiyama
    • 2
    • 4
  • Shinji Ohno
    • 1
  1. 1.Breast Oncology CenterThe Cancer Institute Hospital of the Japanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Division of PathologyThe Cancer Institute of the Japanese Foundation for Cancer ResearchTokyoJapan
  3. 3.Department of Comprehensive Pathology, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
  4. 4.Department of PathologyThe Cancer Institute Hospital of the Japanese Foundation for Cancer ResearchTokyoJapan
  5. 5.Department of Diagnostic Radiology CenterThe Cancer Institute Hospital of the Japanese Foundation for Cancer ResearchTokyoJapan

Personalised recommendations