Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752, Korea. ; Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul 130-872, Korea.
Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752, Korea.
Korean J Radiol. 2014 Nov-Dec;15(6):697-703. doi: 10.3348/kjr.2014.15.6.697. Epub 2014 Nov 7.
To evaluate the upgrade rate and delayed false-negative results of percutaneous vacuum-assisted removal (VAR) and surgical excision in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy (CNB) of the breast and to validate the role of VAR as a rebiopsy method for these discordant lesions.
Percutaneous US-guided 14-gauge CNB was performed on 7470 patients between August 2005 and December 2010. Our study population included 161 lesions in 152 patients who underwent subsequent rebiopsy due to imaging-histologic discordance. Rebiopsy was performed using VAR (n = 88) or surgical excision (n = 73). We investigated the upgrade rate immediately after rebiopsy and delayed false-negative results during at least 24 months of follow-up after rebiopsy. We also evaluated the clinicoradiological differences between VAR and surgical excision.
Total upgrade to malignancy occurred in 13.7% (22/161) of lesions at rebiopsy including both VAR and surgical excision: 4.6% (4/88) of VAR cases (4/88) and 24.7% (18/73) of surgical excision cases (p < 0.001). Surgical excision was performed significantly more frequently in older patients and for larger-sized lesions than that of VAR, and a significant difference was detected between VAR and surgical excision in the Breast Imaging and Reporting and Data System category (p < 0.007). No delayed false-negative results were observed after VAR or surgical excision during the follow-up period.
Long-term follow-up data showed no delayed cancer diagnoses after US-guided VAR in imaging-histologic discordant lesions of the breast, suggesting that VAR might be a rebiopsy method for these lesions.
评估在超声（US）引导下自动核心针活检（CNB）中乳腺影像学-组织学不一致的女性中经皮真空辅助切除（VAR）和手术切除的升级率和延迟假阴性结果，并验证 VAR 作为这些不一致病变的再活检方法的作用。
2005 年 8 月至 2010 年 12 月期间，对 7470 例患者进行了经皮 US 引导下 14 号针 CNB。我们的研究人群包括 152 例患者的 161 个病变，这些患者因影像学-组织学不一致而行后续再活检。再活检采用 VAR（n = 88）或手术切除（n = 73）。我们研究了再活检后立即的升级率和再活检后至少 24 个月随访期间的延迟假阴性结果。我们还评估了 VAR 和手术切除之间的临床影像学差异。
再活检时总恶性升级率为 13.7%（22/161），包括 VAR 和手术切除：VAR 病例为 4.6%（4/88），手术切除病例为 24.7%（18/73）（p < 0.001）。与 VAR 相比，手术切除在老年患者和较大病变中更频繁地进行，VAR 和手术切除之间在乳房成像和报告及数据系统分类方面存在显著差异（p < 0.007）。VAR 或手术切除后在随访期间未观察到延迟假阴性结果。
长期随访数据显示，US 引导下 VAR 治疗乳腺影像学-组织学不一致性病变后无延迟癌症诊断，表明 VAR 可能是这些病变的再活检方法。
