Discrepancies between radiological and histological findings in preoperative core needle (CNB) and vacuum-assisted (VAB)
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ORIGINAL ARTICLE – CANCER RESEARCH
Discrepancies between radiological and histological findings in preoperative core needle (CNB) and vacuum‑assisted (VAB) breast biopsies Inna Jörg1,5 · Jann Wieler2 · Constanze Elfgen3,4 · Kristina Bolten5 · Claudia Hutzli6 · Julia Talimi7,8 · Denise Vorburger7,8 · Matthias Choschzick9 · Linda Moskovszky9 · Konstantin Dedes7,8 · Zsuzsanna Varga8,9 Received: 27 July 2020 / Accepted: 22 November 2020 © The Author(s) 2020
Abstract Background Ultrasound (US)-guided breast biopsy is a routine diagnostic method used to correlate imaging finding to a histological diagnosis which is still the gold standard in preoperative diagnostics. The accuracy of US-guided breast biopsies relies on a precise radiologic-histopathologic correlation, which is discussed amongst an interdisciplinary team of gynecologists, radiologists and pathologists. However, false-negative or non-diagnostic biopsy results occur. Hence, a thorough and honest discussion to clarify the reason for discrepancies and to decide the next diagnostic step between specialists of the different disciplines is warranted. In this retrospective study, we analyzed discrepant findings between imaging and pathology results on preoperative breast biopsies. Methods Core and vacuum-assisted breast biopsies from 232 patients were included in this study. Inclusion criteria were (1) non-diagnostic (B1) category on histology independent from imaging category and (2) histological benign (B2) category with a BIRADS 5 (Breast Imaging Reporting and Data System) rating on imaging. Histological diagnoses were retrieved from all cases. Follow-up data were available in most cases. Results 138 biopsies were classified as B1, 94 biopsies as B2 category. 51 of 138 B1 cases (37%) underwent re-biopsy. Rebiopsy found malignancy (B5) in 19 of 51 cases, and B3/4 (premalignant) lesions in 3 of 51 cases. All B2 cases underwent second-look imaging-diagnosis, in 57 of 94 cases (66%) consecutive direct surgery or re-biopsy. Of these, malignancy was diagnosed histologically in 26 of 57 cases (45.6%). Conclusion Determining imaging-pathology concordance after US-guided breast biopsy is essential. Discrepant cases and further diagnostic steps need to be discussed with an interdisciplinary approach. Keywords Breast biopsy · Discrepancy · Imaging · Histology
* Zsuzsanna Varga [email protected] 1
Department of Gynecology, Hospital Triemli, Zurich, Switzerland
2
Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
3
Breast Center Seefeld, Zurich, Switzerland
4
Department of Radiology, University Witten-Herdecke, Witten, Germany
5
Department of Gynecology, Hospital Zollikerberg, Zollikerberg, Switzerland
6
Department of Gynecology, Hospital Männedorf, Zurich, Switzerland
7
Breast Center, University Hospital Zurich, Zurich, Switzerland
8
Comprehensive Cancer Center Zurich, University Hospital Zurich, Zurich, Switzerland
9
Institute of Pathology and Molecular Pathology, University Hospital Zuric
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