Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, New York, New York.
Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, New York, New York.
J Am Coll Radiol. 2018 Apr;15(4):622-629. doi: 10.1016/j.jacr.2017.12.034. Epub 2018 Feb 9.
To evaluate whether false-positive stereotactic vacuum-assisted breast biopsy (SVAB) affects subsequent mammographic screening adherence.
This Institutional Review Board-approved, HIPAA-compliant retrospective review of women with SVAB was performed between 2012 and 2014. Patient age, clinical history, biopsy pathology, and first postbiopsy screening mammogram were reviewed. Statistical analyses were performed using Fisher's exact, Mann-Whitney, and χ tests.
There were 913 SVABs performed in 2012 to 2014 for imaging detected lesions; of these, malignant or high-risk lesions or biopsies resulting in a recommendation of surgical excision were excluded, leaving 395 SVABs yielding benign pathology in 395 women. Findings were matched with a control population consisting of 45,126 women who had a BI-RADS 1 or 2 screening mammogram and did not undergo breast biopsy. In all, 191 of 395 (48.4%) women with a biopsy with benign results and 22,668 of 45,126 (50.2%) women without biopsy returned for annual follow-up >9 months and ≤18 months after the index examination (P = .479). In addition, 57 of 395 (14.4%) women with a biopsy with benign results and 3,336 of 45,126 (7.4%) women without biopsy returned for annual follow-up >18 months after the index examination (P < .001). Older women, women with personal history of breast cancer, and women with postbiopsy complication after benign SVAB were more likely to return for screening (P = .026, P = .028, and P = .026, respectively).
The findings in our study suggest that SVABs with benign results do not negatively impact screening mammography adherence. The previously described "harms" of false-positive mammography and biopsy may be exaggerated.
评估假阳性立体定向真空辅助乳腺活检(SVAB)是否会影响后续的乳房 X 线筛查依从性。
本研究为 2012 年至 2014 年进行的经机构审查委员会批准、符合 HIPAA 标准的回顾性研究,纳入了接受 SVAB 的女性患者。研究分析了患者年龄、临床病史、活检病理和首次活检后筛查性乳房 X 线检查结果。采用 Fisher 精确检验、Mann-Whitney 检验和 χ²检验进行统计学分析。
2012 年至 2014 年期间,共对影像学检测到的病变进行了 913 例 SVAB,其中排除了恶性或高危病变或活检结果建议手术切除的患者,最终纳入 395 例 SVAB 患者,这些患者的活检病理结果均为良性。将这些患者的结果与一个对照组进行匹配,对照组包括 45126 例接受 BI-RADS 1 或 2 级筛查性乳房 X 线检查且未进行乳腺活检的女性。在所有患者中,395 例良性结果活检患者中有 191 例(48.4%)和 45126 例未行活检患者中有 22668 例(50.2%)在指数检查后 9 个月至 18 个月内进行了年度随访(P=0.479)。此外,395 例良性结果活检患者中有 57 例(14.4%)和 45126 例未行活检患者中有 3336 例(7.4%)在指数检查后 18 个月以上进行了年度随访(P<0.001)。较年长的女性、有乳腺癌个人病史的女性和良性 SVAB 后发生活检后并发症的女性更有可能进行筛查(P=0.026、P=0.028 和 P=0.026)。
本研究结果表明,SVAB 结果为良性并不影响乳房 X 线筛查的依从性。此前描述的假阳性乳房 X 线和活检的“危害”可能被夸大了。