Skip to main content

Pathology

  • Chapter
  • First Online:
Absolute Breast Imaging Review

Abstract

Radiology–Pathology correlation is a critical component of the breast imager’s scope of work and has many important functions. Assessing concordance of radiology and pathology results provides an important safety net to prevent false-negative results. It also helps guide future management of the patient who encompasses both radiology and surgical follow-up. Critically, it is the law under the Food and Drug Administration and part of the Mammography Quality Standards Act (MQSA) Medical Outcome Audit. This chapter will reinforce procedural requirements of radiology–pathology correlation, discuss cases of radiology–pathology discordance, identify causes of radiology–pathology discordance, and highlight scenarios surrounding high-risk lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ho CP, et al. Interactive case review of radiologic and pathologic findings from breast biopsy: are they concordant? How do I manage the results? Radiographics. 2013;33(4):E149–52.

    Article  Google Scholar 

  2. Bassett LW, Mahoney MC, Apple SK. Interventional breast imaging: current procedures and assessing for concordance with pathology. Radiol Clin N Am. 2007;45:881–94.

    Article  Google Scholar 

  3. Ikeda DM. Breast imaging: the requisites. 2nd ed. ELSEVIER MOSBY; 2004.

    Google Scholar 

  4. D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA, et al. ACR BI-RADS® atlas, breast imaging reporting and data system. 5th ed. American College of Radiology; 2013.

    Google Scholar 

  5. Schiaffino S, et al. Upgrade rate of percutaneously diagnosed pure atypical ductal hyperplasia: systematic review and meta-analysis of 6458 lesions. Radiology. 2020;294(1):76–86.

    Article  Google Scholar 

  6. 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. Am J Roentgenol. 2009;192(2):341–51.

    Article  Google Scholar 

  7. Hayward JH, Ray KM, Wisner DJ, Joe BN. Follow-up outcomes after benign concordant MRI-guided breast biopsy. Clin Imaging. 2016;40(5):1034–9.

    Article  Google Scholar 

  8. Huang ML, Speer M, Dogan BE, Rauch GM, Candelaria RP, Adrada BE, Hess KR, Yang WT. Imaging-concordant benign MRI-guided vacuum-assisted breast biopsy may not warrant MRI follow-up. Am J Roentgenol. 2017;208(4):916–22.

    Article  Google Scholar 

  9. Hyun Youk J, Kim EK, Kim MJ, Oh KK. Sonographically guided 14-gauge Core needle biopsy of breast masses: a review of 2,420 cases with long-term follow-up. Am J Roentgenol. 2008;190(1):202–7.

    Article  Google Scholar 

  10. Trop I, et al. Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics. 2011;31:1683–99.

    Article  Google Scholar 

  11. Pluguez-Turull CW, Nanyes JE, Quintero CJ, Alizai H, Mais DD, Kist KA, Dornbluth NC. Idiopathic granulomatous mastitis: manifestations at multimodality imaging and pitfalls. Radiographics. 2018;38(2):330–56.

    Article  Google Scholar 

  12. Chaney AW, et al. Primary treatment of cystosarcoma phyllodes of the breast. Cancer. 2000;89(7):1502.

    Article  CAS  Google Scholar 

  13. Barrio AV, et al. Clincopathologic features and long-term outcomes of 293 phyllodes tumors of the breast. Ann Surg Oncol. 2007;14:2961.

    Article  Google Scholar 

  14. Tan PH, et al. Fibroepithelial tumors: WHO classification of tumors of the breast. Int Agency Res Cancer. 2012;4:414–147.

    Google Scholar 

  15. Yamada, et al. Radiologic-pathologic correlation of ductal carcinoma in situ. Radiographics. 2010;30:1183–98.

    Article  Google Scholar 

  16. Mossa-Basha M, et al. Ductal carcinoma in situ of the breast: MR imaging findings with histopathologic correlation. Radiographics. 2010;30:1673–87.

    Article  Google Scholar 

  17. Tirada N, et al. Breast cancer tissue markers, genomic profiling, and other prognostic factors: a primer for radiologists. Radiographics. 2018;38:1902–20.

    Article  Google Scholar 

  18. diFlorio-Alexander RM, Slanetz PJ, Moy L, Baron P, Didwania AD, Heller SL, Holbrook AI, Lewin AA, Lourenco AP, Mehta TS, Niell BL, Stuckey AR, Tuscano DS, Vincoff NS, Weinstein SP, Newell MS. ACR appropriateness criteria® breast imaging of pregnant and lactating women. J Am Coll Radiol. 2018;15(11S):S263–75.

    Article  Google Scholar 

  19. Schackmuth EM, Harlow CL, Norton LW. Milk fistula: a complication after core breast biopsy. Am J Roentgenol. 1993;161(5):961–2.

    Article  CAS  Google Scholar 

  20. Larson KE, Valente SA. Milk fistula: diagnosis, prevention, and treatment. Breast J. 2015;22(1):111–2.

    Article  Google Scholar 

  21. Monticciolo DL, Hajdik RL, Hicks MG, Winford JK, Larkin WR, Vasek JV Jr, Ashton BM. Six-month short-interval imaging follow-up for benign concordant Core needle biopsy of the breast: outcomes in 1444 cases with long-term follow-up. Am J Roentgenol. 2016;207(4):912–7.

    Article  Google Scholar 

  22. Nakhlis F, Baker GM, Pilewskie M, et al. The incidence of adjacent synchronous invasive carcinoma and/or ductal carcinoma in situ in patients with intraductal papilloma without atypia on Core biopsy: results from a prospective multi-institutional registry (TBCRC 034). Ann Surg Oncol. 2021;28(5):2573–8.

    Article  Google Scholar 

  23. Kalli S, et al. American joint committee on Cancer’s staging system for breast cancer, eighth edition: what the radiologist needs to know. Radiographics. 2018;38(7):1921–33.

    Article  Google Scholar 

  24. Alshafeiy TI, et al. Outcome of architectural distortion detected only at breast tomosynthesis versus 2D mammography. Radiology. 2018;288(1):38–46.

    Article  Google Scholar 

  25. Lopez JK, Bassett LW. Invasive lobular carcinoma of the breast: Spectrum of mammographic, US, and MR imaging findings. Radiographics. 2009;29:165–76.

    Article  Google Scholar 

  26. Causer PA, et al. Breast cancers detected with imaging screening in the BRCA population: emphasis on MR imaging with histopathologic correlation. Radiographics. 2007;27:S165–82.

    Article  Google Scholar 

  27. Kim MJ, et al. How to find an isoechoic lesion with breast US. Radiographics. 2011;31:663–76.

    Article  Google Scholar 

  28. Harvey JA. Unusual breast cancers: useful clues to expanding the differential diagnosis. Radiology. 2007;242:683–94.

    Article  Google Scholar 

  29. Gao Y, Slanetz PJ, Eisenberg RL. Echogenic breast masses at US: to biopsy or not to biopsy? Radiographics. 2013;33:419–34.

    Article  Google Scholar 

  30. Linda A, Zuiani C, Lorenzon M, et al. Hyperechoic lesions of the breast: not always benign. Am J Roentgenol. 2011;196(5):1219–24.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Antionette Roth .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chung, S.H., Cain, N., Roth, A. (2022). Pathology. In: Chow, L., Li, B. (eds) Absolute Breast Imaging Review. Springer, Cham. https://doi.org/10.1007/978-3-031-08274-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-08274-0_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-08273-3

  • Online ISBN: 978-3-031-08274-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics