Department of Radiology, Research Institute of Radiological Science, Yonsei University Heath System, Seoul, South Korea.
Clin Radiol. 2011 Jun;66(6):530-5. doi: 10.1016/j.crad.2011.01.008. Epub 2011 Feb 24.
To compare the histological upgrade rate of ultrasound (US)-guided vacuum-assisted removal (VAR) and US-14 G-automated core needle biopsy (ACNB) in the diagnosis of papillary breast lesions.
Two hundred and seventy-one biopsies of 230 papillary lesions were examined, which underwent subsequent surgical excision or long-term follow-up after US-ACNB (n = 206) or US-VAR (n = 65). The false-negative and atypical papilloma underestimation rate were compared between the ACNB and VAR groups. Patient and lesion characteristics were collected. The histological upgrade rates of the diagnosis were estimated and compared.
Out of 271 papillary lesions, 195 (80.0%) were benign, 21 (7.7%) were atypical, and 55 (20.3%) were malignant. There were no false negatives or underestimated atypical papillomas in the VAR group. However, in the ACNB group, the false-negative rate was 7.6% (12 of 157 benign papillomas, 95% CI; 4.4-12.9%, p = 0.039) and the atypical papilloma underestimation rate was 33% (five of 15 atypical papillomas, 95% CI; 15.2-58.3%, p = 0.135). The histological upgrade rates of the diagnosis for papillary breast lesions were 0% for the VAR (0 of 66) group and 10.2% for the ACNB (21 of 206) group before adjusting for the population (p = 0.003).
ACNB was associated with significantly higher false-negative and histological upgrade rates of diagnosis for papillary breast lesions than VAR.
比较超声引导真空辅助切除（VAR）和超声 14G 自动核心针活检（ACNB）在诊断乳头状乳腺病变中的组织学升级率。
对 230 例乳头状病变的 271 例活检进行了检查，这些病变在超声 ACNB（n=206）或超声 VAR（n=65）后进行了后续手术切除或长期随访。比较了 ACNB 和 VAR 组之间的假阴性和不典型乳头状瘤低估率。收集了患者和病变特征。估计和比较了诊断的组织学升级率。
在 271 例乳头状病变中，195 例（80.0%）为良性，21 例（7.7%）为不典型，55 例（20.3%）为恶性。VAR 组无假阴性或不典型乳头状瘤低估。然而，在 ACNB 组中，假阴性率为 7.6%（157 例良性乳头状瘤中有 12 例，95%可信区间；4.4-12.9%，p=0.039），不典型乳头状瘤低估率为 33%（15 例不典型乳头状瘤中有 5 例，95%可信区间；15.2-58.3%，p=0.135）。调整人群后，乳头状乳腺病变的诊断组织学升级率为 VAR（66 例中 0 例）组 0%，ACNB（206 例中 21 例）组 10.2%（p=0.003）。
与 VAR 相比，ACNB 与乳头状乳腺病变的假阴性和诊断组织学升级率显著更高相关。
