Department of Radiology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands.
Department of Surgical Oncology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands.
Eur Radiol. 2022 Nov;32(11):7420-7429. doi: 10.1007/s00330-022-08806-3. Epub 2022 Apr 29.
We determined the failure rate of stereotactic core needle biopsy (SCNB) and its causes and final outcome in women recalled for calcifications at screening mammography.
We included a consecutive series of 624,039 screens obtained in a Dutch screening region between January 2009 and July 2019. Radiology reports and pathology results were obtained of all recalled women during 2-year follow-up.
A total of 3495 women (19.6% of 17,809 recalls) were recalled for suspicious calcifications. SCNB was indicated in 2818 women, of whom 12 had incomplete follow-up and another 12 women refused biopsy. DCIS or invasive cancer was diagnosed in 880 of the remaining 2794 women (31.5%). SCNB failed in 62 women (2.2%, 36/2794). These failures were mainly due to a too posterior (n = 30) or too superficial location (n = 17) of the calcifications or calcifications too faint for biopsy (n = 13). Of these 62 women, 10 underwent surgical biopsy, yielding one DCIS (intermediate grade) and two invasive cancers (one intermediate grade and one high grade) and another two women were diagnosed with DCIS (both high grade) at follow-up. Thus, the malignancy rate after SCNB failure was 8.1% (5/62). Calcifications were depicted neither at SCNB specimen radiography nor at pathology in 16 women after (repeated) SCNB (0.6%, 31/2732). None of them proved to have breast cancer at 2-year follow-up.
The failure rate of SCNB for suspicious calcifications is low but close surveillance is warranted, as breast cancer may be present in up to 8% of these women.
• The failure rate of stereotactic core needle biopsy (SCNB) for calcifications recalled at screening mammography was 2.2%. • Failures were mainly due to calcifications that could not be reached by SCNB or calcifications too faint for biopsy. • The management after failed SCNB was various. At least, close surveillance with a low threshold for surgical biopsy is recommended as breast cancer may be present in up to 8% of women with SCNB failure.
我们确定了在筛查性乳房 X 光摄影中因钙化而召回的女性中立体定向核心针活检（SCNB）的失败率及其原因和最终结果。
我们纳入了 2009 年 1 月至 2019 年 7 月期间在荷兰筛查区域进行的连续 624039 次筛查。在 2 年的随访期间，我们获得了所有召回女性的放射学报告和病理结果。
共有 3495 名女性（17809 次召回中的 19.6%）因可疑钙化而被召回。在 2818 名女性中指示进行 SCNB，其中 12 名女性未完成随访，另有 12 名女性拒绝活检。在其余 2794 名女性中，880 名女性被诊断为 DCIS 或浸润性癌。在 36 名（2.2%，36/2794）女性中 SCNB 失败。这些失败主要是由于钙化的位置太靠后（n=30）或太浅（n=17），或者钙化太淡而无法进行活检（n=13）。在这 62 名女性中，10 名接受了手术活检，其中 1 名被诊断为 DCIS（中等级别）和 2 名浸润性癌（1 名中等级别和 1 名高等级别），另外 2 名女性在随访中被诊断为 DCIS（均为高级别）。因此，SCNB 失败后的恶性肿瘤发生率为 8.1%（5/62）。在（重复）SCNB 后 16 名女性（0.6%，31/2732）的 SCNB 标本 X 光片和病理上均未显示钙化。在 2 年的随访中，她们均未被证实患有乳腺癌。
可疑钙化的 SCNB 失败率较低，但需要密切监测，因为这些女性中多达 8%可能患有乳腺癌。
筛查性乳房 X 光摄影中因钙化而召回的女性中，立体定向核心针活检（SCNB）的失败率为 2.2%。
失败主要是由于无法通过 SCNB 触及的钙化或钙化太淡而无法进行活检。
SCNB 失败后的处理方式各不相同。至少，推荐密切监测，对手术活检的门槛要低，因为 SCNB 失败的女性中可能有多达 8%患有乳腺癌。
