Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252, USA.
Radiology. 2011 Feb;258(2):380-7. doi: 10.1148/radiol.10091824. Epub 2010 Nov 15.
To determine the utility of 6-month follow-up imaging after benign concordant image-guided percutaneous breast biopsy results.
The institutional review board approved this retrospective, HIPAA-compliant study; informed consent was waived. Findings from consecutive stereotactic and ultrasonographically guided core breast biopsies performed from 2001 to 2005 were analyzed and included lesions with benign pathologic findings without atypia found to be concordant with imaging at a consensus conference. Rebiopsy recommendation rates and positive predictive values (PPVs) for detecting malignancy at each follow-up interval were measured and compared by using a two-tailed Fisher exact test.
In 2244 biopsies, lesions in 1465 were benign, concordant, and not excised. In 1057 of 1465 (72.2%) biopsies with imaging follow-up (average, 26.4 months; range, 4.0-49.9 months), recommended rebiopsy rates were 0.8% (four of 526), 0.5% (three of 588), and 1.0% (eight of 802) at 6-month, 12-month, and long-term follow-up intervals, respectively. When the initial follow-up did not occur until 12 months, the recommended rebiopsy rate was 0.9% (three of 322), compared with 0.8% (four of 526) at 6 months (P > .99), and no malignancies were found in either group. One malignancy was detected at the long-term follow-up interval (PPV for excision recommended, 12% [one of eight]; PPV for excision performed, 20% [one of five]).
Because rebiopsy recommendation rates and PPVs did not differ in the 6- and 12-month groups, a 6-month follow-up imaging examination, in the context of a formal concordancy consensus conference, may not contribute to improved breast cancer diagnosis.
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10091824/-/DC1.
确定良性一致影像学引导经皮乳腺活检结果后 6 个月随访成像的效用。
本回顾性研究获得机构审查委员会批准，符合 HIPAA 规定；豁免了知情同意。分析了 2001 年至 2005 年间连续进行的立体定向和超声引导核心乳腺活检的结果，包括在共识会议上发现与影像学表现一致的无典型表现的良性病理发现的病变。通过使用双侧 Fisher 精确检验，测量并比较了每个随访间隔的恶性肿瘤再活检推荐率和阳性预测值 (PPV)。
在 2244 次活检中，1465 次活检的病变为良性、一致且未切除。在 1465 次活检中有 1057 次（平均 26.4 个月；范围 4.0-49.9 个月）进行了影像学随访，在 6 个月、12 个月和长期随访间隔时，再活检推荐率分别为 0.8%（526 例中的 4 例）、0.5%（588 例中的 3 例）和 1.0%（802 例中的 8 例）。如果初始随访延迟到 12 个月，则再活检推荐率为 0.9%（322 例中的 3 例），与 6 个月时的 0.8%（526 例中的 4 例）相比无显著差异（>.99），且两组均未发现恶性肿瘤。在长期随访间隔时发现 1 例恶性肿瘤（切除推荐的 PPV 为 12%[8 例中的 1 例]；切除执行的 PPV 为 20%[5 例中的 1 例]）。
由于 6 个月和 12 个月组的再活检推荐率和 PPV 没有差异，因此在正式的一致性共识会议背景下，6 个月的随访成像检查可能不会有助于改善乳腺癌的诊断。
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10091824/-/DC1.
