Controversies on the Management of High-Risk Lesions at Core Biopsy from a Radiology/Pathology Perspective

Radiologic Clinics of North America

Volumn 48, Issue 5, 2010, Pages 999-1012

  Georgian Smith, Dianne ^a   Lawton, Thomas J ^b,c  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

^b Seattle Breast Pathology Consultants   (United States)

^c Clarient Inc   (United States)

Author keywords

Breast core biopsy; Breast high risk lesion; Flat epithelial atypia (FEA); Lobular neoplasia; Papilloma; Radial scar

Indexed keywords

BENIGN TUMOR; BREAST BIOPSY; BREAST CARCINOMA; BREAST HYPERPLASIA; BREAST PAPILLOMA; BREAST TUMOR; CANCER INVASION; CANCER LOCALIZATION; CANCER SURGERY; CARCINOMA IN SITU; DIAGNOSTIC ACCURACY; FLAT EPITHELIA ATYPIA; HUMAN; IMAGE ANALYSIS; INCIDENTAL FINDING; MALIGNANT TRANSFORMATION; MAMMOGRAPHY; MASTECTOMY; NEEDLE BIOPSY; NUCLEAR MAGNETIC RESONANCE IMAGING; PREVALENCE; PRIORITY JOURNAL; REVIEW; RISK FACTOR; SCAR; ADULT; AGED; BREAST; BREAST NEOPLASMS; CARCINOMA, DUCTAL, BREAST; CARCINOMA, LOBULAR; COMPARATIVE STUDY; ECHOMAMMOGRAPHY; FEMALE; FOLLOW UP; PATHOLOGY; PROCEDURES; RADIOGRAPHY; RISK ASSESSMENT; TUMOR INVASION; TUMOR RECURRENCE;

ADULT; AGED; BIOPSY, NEEDLE; BREAST; BREAST NEOPLASMS; CARCINOMA IN SITU; CARCINOMA, DUCTAL, BREAST; CARCINOMA, LOBULAR; FEMALE; FOLLOW-UP STUDIES; HUMANS; MAMMOGRAPHY; NEOPLASM INVASIVENESS; NEOPLASM RECURRENCE, LOCAL; RISK ASSESSMENT; ULTRASONOGRAPHY, MAMMARY;

EID: 77956942588     PISSN: 00338389     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.rcl.2010.06.004     Document Type: Review

References (105)

1. Berg W. Image-guided breast biopsy and management of high-risk lesions. Radiol Clin North Am 2004, 42:935-946.
2. Lawton T.L., Georgian-Smith D. Excision of high-risk breast lesions on needle biopsy: is there a standard of core?. AJR Am J Roentgenol 2009, 192:W268.
3. Jackman R.J., Burbank F., Parker S.H., et al. Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted biopsy. Radiology 1997, 204:485-488.
4. Brem R.F., Behrndt V.S., Sanow L., et al. Atypical ductal hyperplasia: histologic underestimation of carcinoma in tissue harvested from impalpable breast lesions using 11-gauge stereotactically guided directional vacuum-assisted biopsy. AJR Am J Roentgenol 1999, 172:1405-1407.
5. Philpotts L.E., Lee C.H., Horvath L.J., et al. Underestimation of breast cancer with 11-gauge vacuum suction biopsy. AJR Am J Roentgenol 2000, 175:1047-1050.
6. Jackman R.J., Birdwell R.L., Ikeda D.M. Atypical ductal hyperplasia: can some lesions be defined as probably benign after stereotactic 11g vacuum-assisted biopsy, eliminating the recommendation for surgical excision?. Radiology 2002, 224:548-554.
7. Li C., Daling J.R., Malone K.E. Age-specific incidence rates of in situ breast carcinomas by histologic type 1980-2001. Cancer Epidemiol Biomarkers Prev 2005, 14:1008-1011.
8. Page D.L., Dupont W.D., Rogers L.W., et al. Atypical hyperplastic lesions of the female breast. A long-term follow-up study. Cancer 1985, 55(11):2698-2708.
9. Simpson P.T., Gale T., Fulford L.G., et al. The diagnosis and management of pre-invasive breast disease: pathology of atypical lobular hyperplasia and lobular carcinoma in situ. Breast Cancer Res 2003, 5(5):258-262.
10. Wheeler J.E., Enterline H.T., Roseman J.M., et al. Lobular carcinoma in situ of the breast. Long-term follow-up. Cancer 1974, 34(3):554-563.
11. Rosen P.P., Kosloff C., Lieberman P.H., et al. Lobular carcinoma in situ of the breast. Detailed analysis of 99 patients with average follow-up of 24 years. Am J Surg Pathol 1978, 2(3):225-251.
12. Dupont W.D., Page D.L. Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med 1985, 312(3):146-151.
13. Georgian-Smith D., Lawton T.J. Calcifications of lobular carcinoma in situ of the breast: radiologic and pathologic correlation. AJR Am J Roentgenol 2001, 176(5):1255-1259.
14. Jacobs T.W., Pliss N., Kouria G., et al. Carcinomas in situ of the breast with indeterminate features: role of E-cadherin staining in categorization. Am J Surg 2001, 25(2):229-236.
15. Maluf H.M., Swanson P.E., Koerner F.C. Solid low-grade in situ carcinoma of the breast: role of associated lesions and E-cadherin in differential diagnosis. Am J Surg Pathol 2001, 25(2):237-244.
16. Sneige N., Wang J., Baker B.A., et al. Clinical, histopathologic, and biologic features of pleomorphic lobular (ductal-lobular) carcinoma in situ of the breast: a report of 24 cases. Mod Pathol 2002, 15(10):1044-1050.
17. Fadare O., Dadmanesh F., Alvarado-Cabrero I., et al. Lobular intraepithelial neoplasia [lobular carcinoma in situ] with comedo-type necrosis: a clinicopathologic study of 18 cases. Am J Surg Pathol 2006, 30(11):1445-1453.
18. Philpotts L.E., Shaheen N.A., Jain K.S., et al. Uncommon high-risk lesions of the breast diagnosed at stereotactic core-needle biopsy: clinical importance. Radiology 2000, 216(3):831-837.
19. Rosen P.P. Lobular carcinoma in situ and atypical lobular hyperplasia. Rosen's breast pathology 1997, 507-544. Lippincott-Raven, Philadelphia. P.P. Rosen (Ed.).
20. Rebner M., Raju U. Noninvasive breast cancer. Radiology 1994, 190:623-631.
21. Sapino A., Frigerio A., Peterse J.L., et al. Mammographically detected in situ lobular carcinomas of the breast. Virchows Arch 2000, 436(5):421-430.
22. Stein L.F., Zisman G., Rapelyea J.A., et al. Lobular carcinoma in situ of the breast presenting as a mass. AJR Am J Roentgenol 2005, 184:1799-1801.
23. Tarjan G, Wiley EL, Spilde J, et al. Image detected lobular neoplasia of breast: morphologic correlation with imaging lesions. Scientific poster presentations. 23rd Annual San Antonio Breast Cancer Symposium. San Antonio (TX), December 6-9, 2000.
24. Arpino G., Allred D.C., Mohsin S.K., et al. Lobular neoplasia on core-needle biopsy - clinical significance. Cancer 2004, 101(2):242-250.
25. Zuiani C., Londero V., Bestagno A., et al. Proliferative high-risk lesions of the breast: contribution and limits of US guided core biopsy. Radiol Med 2005, 110(5-6):589-602.
26. Margenthaler J.A., Duke D., Monsees B.S., et al. Correlation between core biopsy and excisional biopsy in breast high-risk lesions. Am J Surg 2006, 192(4):534-537.
27. Mahoney M.C., Robinson-Smith T.M., Shaughnessy E.A. Lobular neoplasia at 11-gauge vacuum-assisted stereotactic biopsy: correlation with surgical excisional biopsy and mammographic follow-up. AJR Am J Roentgenol 2006, 187:949-954.
28. Londero V., Zuiani C., Linda A., et al. Lobular neoplasia: core needle breast biopsy underestimation of malignancy in relation to radiologic and pathologic features. Breast 2008, 17(6):623-630.
29. Elsheikh T.M., Silverman J.F. Follow-up surgical excision is indicated when breast core needle biopsies show atypical lobular hyperplasia or lobular carcinoma in situ: a correlative study of 33 patients with review of the literature. Am J Surg Pathol 2005, 29(4):534-543.
30. Lavoue V., Graesslin O., Classe J.M., et al. Management of lobular neoplasia diagnosed by core needle biopsy: study of 52 biopsies with follow-up surgical excision. Breast 2007, 16(5):533-539.
31. Brem R.F., Lechner M.C., Jackman R.J., et al. Lobular neoplasia at percutaneous breast biopsy: variables associated with carcinoma at surgical excision. AJR Am J Roentgenol 2008, 190(3):637-641.
32. Anderson B.O., Calhoun K.E., Rosen E.L. Evolving concepts in the management of lobular neoplasia. J Natl Compr Canc Netw 2006, 4(5):511-522.
33. Kopans D.B. Lobular neoplasia on core-needle biopsy - clinical significance. Cancer 2004, 101(12):2902-2903.
34. Kopans D.B. LCIS found at core needle biopsy may not need surgical excision. AJR Am J Roentgenol 2008, 191:W152.
35. Menon S., Porter G.J., Evans A.J., et al. The significance of lobular neoplasia on needle core biopsy of the breast. Virchows Arch 2008, 452(5):473-479.
36. Nagi C.S., O'Donnell J.E., Tismenetsky M., et al. Lobular neoplasia on core needle biopsy does not require excision. Cancer 2008, 112(10):2152-2158.
37. Hwang H., Barke L.D., Mendelson E.B., et al. Atypical lobular hyperplasia and classic lobular carcinoma in situ in core biopsy specimens: routine excision is not necessary. Mod Pathol 2008, 21:1208-1216.
38. Chuba P.J., Hamre M.R., Yap J., et al. Bilateral risk for subsequent breast cancer after lobular carcinoma-in-situ: analysis of surveillance, epidemiology, and end results data. J Clin Oncol 2005, 23(24):5534-5541.
39. Page D.L., Simpson J.F. What is atypical lobular hyperplasia and what does it mean for the patient?. J Clin Oncol 2005, 23(24):5432-5433.
40. Mulheron B., Gray R.J., Pockaj B.A., et al. Is excisional biopsy indicated for patients with lobular neoplasia diagnosed on percutaneous core needle biopsy of the breast?. Am J Surg 2009, 198(6):792-797.
41. Sohn V.Y., Arthurs Z.M., Kim F.S., et al. Lobular neoplasia: is surgical excision warranted?. Am Surg 2008, 74(2):172-177.
42. Page D.L., Salhany K.E., Jensen R.A., et al. Subsequent breast carcinoma risk after biopsy with atypia in a breast papilloma. Cancer 1996, 78(2):258-266.
43. Collins L.C., Schnitt S.J. Papillary lesions of the breast: selected diagnostic and management issues. Histopathology 2008, 52(1):20-29.
44. Lewis J.T., Hartmann L.C., Vierkant R.A., et al. An analysis of breast cancer risk in women with single, multiple, and atypical papilloma. Am J Surg Pathol 2006, 30(6):665-672.
45. Harjit K., Willsher P.C., Bennett M., et al. Multiple papillomas of the breast: is current management adequate?. Breast 2006, 15:777-781.
46. Sakr R., Rouzier R., Salem C., et al. Risk of breast cancer associated with papilloma. Eur J Surg Oncol 2008, 34:1304-1308.
47. Rizzo M., Lund M.J., Oprea G., et al. Surgical follow-up and clinical presentation of 142 breast papillary lesions diagnosed by ultrasound-guided core-needle biopsy. Ann Surg Oncol 2008, 15(4):1040-1047.
48. Shin H.J., Kim H.H., Kim S.M., et al. Papillary lesions of the breast diagnosed at percutaneous sonographically guided biopsy: comparison of sonographic features and biopsy methods. AJR Am J Roentgenol 2008, 190:630-636.
49. Tseng H.S., Chen Y.L., Chen S.T., et al. The management of papillary lesion of the breast by core needle biopsy. Eur J Surg Oncol 2009, 35:21-24.
50. Agoff S.N., Lawton T.J. Papillary lesions of the breast with and without atypical ductal hyperplasia: can we accurately predict benign behavior from core needle biopsy?. Am J Clin Pathol 2004, 122(3):440-443.
51. Arora N., Hill C., Hoda S.A., et al. Clinicopathologic features of papillary lesions on core needle biopsy of the breast predictive of malignancy. Am J Surg 2007, 194(4):444-449.
52. Carder P.J., Garvican J., Haigh I., et al. Needle core biopsy can reliably distinguish between benign and malignant papillary lesions of the breast. Histopathology 2005, 46:320-327.
53. Sydnor M.K., Wilson J.D., Hijaz T.A., et al. Underestimation of presence of breast carcinoma in papillary lesions initially diagnosed at core-needle biopsy. Radiology 2007, 242(1):58-62.
54. Zografos G.C., Zagouri F., Sergentanis T.N., et al. Diagnosing papillary lesions using vacuum-assisted breast biopsy: should conservative or surgical management follow?. Onkologie 2008, 31:653-656.
55. Carder P.J., Khan T., Burrows P., et al. Large volume " mammotome" biopsy may reduce the need for diagnostic surgery in papillary lesions of the breast. J Clin Pathol 2008, 61:923-933.
56. Liberman L., Tornos C., Huzjan R., et al. Is surgical excision warranted after benign, concordant diagnosis of papilloma at percutaneous breast biopsy?. AJR Am J Roentgenol 2006, 186:1328-1334.
57. Ko E.S., Cho N., Cha J.H., et al. Sonographically-guided 14 gauge core needle biopsy for papillary lesions of the breast. Korean J Radiol 2007, 8(3):206-211.
58. Mercado C.L., Hamele-Bena D., Oken S.M., et al. Papillary lesions of the breast at percutaneous core-needle biopsy. Radiology 2006, 238(3):801-808.
59. Skandarajah A.R., Field L., Yuen Larn Mou A., et al. Benign papilloma on core biopsy requires surgical excision. Ann Surg Oncol 2008, 15(8):2272-2277.
60. Bernik S.F., Troob S., Ying B.L., et al. Papillary lesions of the breast diagnosed by core needle biopsy: 71 cases with surgical follow-up. Am J Surg 2009, 197(4):473-478.
61. Jaffer S., Nagi C., Bleiweiss I.J. Excision is indicated for intraductal papilloma of the breast diagnosed on core needle biopsy. Cancer 2009, 115(13):2837-2843.
62. Sahasrabudhe N., Beetles U., Coyne J. Accuracy of needle core biopsies in the diagnosis of papillary breast lesions. Histopathology 2006, 49:91.
63. ® - Ultrasound, American College of Radiology, Reston (VA). 1st edition.
64. Lam W.W., Chu W.C., Tang A.P., et al. Role of radiologic features in the management of papillary lesions of the breast. AJR Am J Roentgenol 2006, 188:1322-1327.
65. Chang JM, Moon WK, Cho N, et al. Ultrasound detected benign papilloma diagnosed at percutaneous breast biopsy: upgrade rate at surgical excision. Scientific session SSK01-05 [abstract]. Radiological Society of North America 95th Scientific Assembly and Annual Meeting. Chicago (IL), November 29 to December 4, 2009. p. 521.
66. Kil W.H., Cho E.Y., Kim J.H., et al. Is surgical excision necessary in benign papillary lesions initially diagnosed at core biopsy?. Breast 2008, 17:258-262.
67. Page D., Anderson T. Radial scars and complex sclerosing lesions. Diagnostic histopathology of the breast 1987, 89-103. Page D, Churchill Livingston, Edinburgh (UK). T. Anderson (Ed.).
68. Lopez-Medina A., Cintora E., Mugica B., et al. Radial scars diagnosed at stereotactic core-needle biopsy: surgical biopsy findings. Eur Radiol 2006, 16:1803-1810.
69. Becker L., Trop I., David J., et al. Management of radial scars found at percutaneous breast biopsy. Can Assoc Radiol J 2006, 57(2):72-78.
70. Brenner R.J., Jackman R.J., Parker S.H., et al. Percutaneous core needle biopsy of radial scars: when is excision necessary?. AJR Am J Roentgenol 2002, 179:1179-1184.
71. Resetkova E., Edelweiss M., Albarracin C.T., et al. Management of radial sclerosing lesions of the breast diagnosed using percutaneous vacuum-assisted core needle biopsy: recommendations for excision based on seven years' of experience at a single institution. Breast Cancer Res Treat 2008, [Epub ahead of print].
72. Cawson J.N., Malara F., Kavanagh A., et al. Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary?. Cancer 2003, 97(2):345-351.
73. Linda A., Zuiani C., Furlan A., et al. Radial scars without atypia diagnosed at image-guided needle biopsy: how often is associated malignancy found at subsequent surgical excision, and do mammography and sonography predict which lesions are malignant?. AJR Am J Roentgenol 2010, 194(4):1146-1151.
74. Douglas-Jones A.G., Denson J.L., Cox A.C., et al. Radial scar lesions of the breast diagnosed by needle core biopsy: analysis of cases containing occult malignancy. J Clin Pathol 2007, 60(3):295-298.
75. Rosai J. Borderline epithelial lesions of the breast. Am J Surg Pathol 1991, 15(3):209-221.
76. Schnitt S.J., Connolly J.L., Tavassoli F.A., et al. Interobserver reproducibility in the diagnosis of ductal proliferative breast lesions using standardized criteria. Am J Surg Pathol 1992, 16(12):1133-1143.
77. Brodie C., O'Doherty A., Quinn C. Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary? [letter to the editor]. Cancer 2004, 100(3):652-653.
78. Cawson J.N., Hill P., Henderson M. Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary?. Cancer 2004, 100(3):653-654. Author reply letter to the editor.
79. Tavassoli F.A., Hoefler H., Rosai J., et al. Intraductal proliferative lesions. World Health Organization classification of tumors of the breast and female genital organs 2003, 63-75. IARC Press, Lyon (France). F.A. Tavassoli, P. Devillee (Eds.).
80. Pandey S., Kornstein M.J., Shanke W., et al. Columnar cell lesions of the breast: mammographic findings with histopathologic correlation [special issue]. Radiographics 2007, 27(Suppl 1):79-89.
81. Goldstein N.S., O'Malley B.A. Cancerization of small ectatic ducts of the breast by ductal carcinoma in situ cells with apocrine snouts: a lesion associated with tubular carcinoma. Am J Clin Pathol 1997, 107(5):561-566.
82. Oyama T., Maluf H., Koerner F. Atypical cystic lobules: an early stage in the formation of low-grade ductal carcinoma in situ. Virchows Arch 1999, 435(4):413-421.
83. Rosen P.P. Columnar cell hyperplasia is associated with lobular carcinoma in situ and tubular carcinoma. Am J Surg Pathol 1999, 23(12):1561.
84. Brogi E., Oyama T., Koerner F.C. Atypical cystic lobules in patients with lobular neoplasia. Int J Surg Pathol 2001, 9(3):201-206.
85. Bratthauer G.L., Tavassoli F.A. Assessment of lesions coexisting with various grades of ductal intraepithelial neoplasia of the breast. Virchows Arch 2004, 444(4):340-344.
86. Abdel-Fatah T.M., Powe D.G., Hodi Z. High frequency of coexistence of columnar cell lesions, lobular neoplasia, and low grade ductal carcinoma in situ with invasive tubular carcinoma and invasive lobular carcinoma. Am J Surg Pathol 2007, 31(3):417-426.
87. Collins L.C., Achacoso N.A., Nekhlyudov L., et al. Clinical and pathologic features of ductal carcinoma in situ associated with the presence of flat epithelial atypia: an analysis of 543 patients. Mod Pathol 2007, 20(11):1149-1155.
88. Leibl S., Regitnig P., Moinfar F. Flat epithelial atypia (DIN 1a, atypical columnar change): an under diagnosed entity very frequently coexisting with lobular neoplasia. Histopathology 2007, 50(7):859-865.
89. Schnitt S.J. The diagnosis and management of pre-invasive breast disease: flat epithelial atypia - classification, pathologic features and clinical significance. Breast Cancer Res 2003, 5(5):263-268.
90. Lerwill M.F. Flat epithelial atypia of the breast. Arch Pathol Lab Med 2008, 132(4):615-621.
91. Moinfar F. Flat ductal intraepithelial neoplasia of the breast: a review of diagnostic criteria, differential diagnoses, molecular-genetic findings, and clinical relevance - it is time to appreciate the Azzopardi concept!. Arch Pathol Lab Med 2009, 133(6):879-892.
92. David N., Labbe-Devilliers C., Moreau D., et al. Lesions de metaplasie cylindriques atypiques (MCA) diagnostiquees par macrobiopsies assistees par aspiration: opportunite d'une exerese chirugicale?. J Radiol 2006, 87(11):1671-1677. [in French].
93. Martel M., Barron-Rodirguez P., Ocal I.T., et al. Flat DIN (flat epithelial atypia) on core needle biopsy: 63 cases identified retrospectively among 1,751 core biopsies performed over an 8-year period (1992-1999). Virchows Arch 2007, 451:883-891.
94. Darvishian F., Singh B., Simsir A., et al. Atypia on breast core needle biopsies: reproducibility and significance. Ann Clin Lab Sci 2009, 39(3):270-276.
95. Ingegnoli A., D'Aloia C., Frattaruolo A., et al. Flat epithelial atypical and atypical ductal hyperplasia: carcinoma underestimation rate. Breast J 2009, 13:1-5.
96. Kunju L.P., Kleer C.G. Significance of flat epithelial atypia on mammotome core needle biopsy: should it be excised?. Hum Pathol 2007, 38(1):35-41.
97. Senetta R., Campanino P.P., Mariscotti G., et al. Columnar cell lesions associated with breast calcifications on vacuum-assisted core biopsies: clinical, radiographic, and histologic correlations. Mod Pathol 2009, 22:762-769.
98. Piubello Q., Parisi A., Eccher A., et al. Flat epithelial atypia on core needle biopsy: which is the right management?. Am J Surg Pathol 2009, 33(7):1078-1084.
99. Noel J.C., Buxant F., Engohan-Aloghe C. Immediate surgical resection of residual microcalcifications after a diagnosis of pure flat epithelial atypia on core biopsy: a word of caution. Surg Oncol 2009, 58. [Epub ahead of print].
100. Tan P.H., Ho B.C., Selvarajan S., et al. Pathological diagnosis of columnar cell lesions of the breast: are there issues of reproducibility?. J Clin Pathol 2005, 58:705-709.
101. O'Malley F.P., Mohsin S.K., Badve S., et al. Interobserver reproducibility in the diagnosis of flat epithelial atypia of the breast. Mod Pathol 2006, 19:172-179.
102. Linda A., Zuiani C., Bazzocchi M., et al. Borderline breast lesions diagnosed at core needle biopsy: can magnetic resonance mammography rule out associated malignancy? Preliminary results based on 79 surgically excised lesions. Breast 2008, 17:125-131.
103. Pediconi F., Occhiato R., Venditti F., et al. Radial scars of the breast: contrast enhanced magnetic resonance mammography appearance. Breast J 2005, 11(1):23-28.
104. Sadaf A, Bukhanov K, McCready DR, et al. High risk breast lesions diagnosed with MRI guided vacuum-assisted breast biopsy (MRgVABB): can underestimation be predicted? [abstract SSK01-09] Radiological Society of North America 95th Scientific Assembly and Annual Meeting. Chicago (IL), November 29 to December 4, 2009. p. 522-3.
105. Orel S.G., Rosen M., Mies C., et al. MR imaging-guided 9-gauge vacuum-assisted core-needle breast biopsy: initial experience. Radiology 2006, 238(1):54-61.