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 IJCM  Vol.9 No.5 , May 2018
Stereotactic Core Biopsy Following Screening Mammography: A Danish Retrospective National Cohort Study
Abstract: Background: Since introducing stereotactic core biopsy (SCB) on breast lesions in Denmark, no national follow-up of the procedure has been executed. Purpose: To evaluate performance of SCB in Danish mammography screening. 3 areas were selected for evaluation: diagnostic value of SCB, performance of the Danish 7-tier mamma-radiological classifications system, DKBI-RADS, and diagnostic delay for SCB-diagnosis. Materials & Methods: Danish retrospective national cohort study including 2195 screening patients undergoing SCB. Study period: 01.01.2010 to 30.09.2012. Patients were identified from The Danish National Patient Register. Pathology-data were obtained from the Danish Pathology Database. Radiological-data according to DKBI-RADS were recorded. Diagnostic delay from clinical mammography until diagnosis was registered. Results: 173 SCBs indicated cancer; all operated with 3 cases finalized as benign. 1296 cases were determined benign with diagnostic surgery in 81 cases of which 31 were concluded pre-malignant/malignant. Correlation between DKBI-RADS and pathology diagnosis: 329 of 485 DKBI-RADS3, 227 of 450 DKBI-RADS4 were benign. 4 of 16 DKBI-RADS5 were benign. The diagnostic value of pre-malignant/malignant SCB related to results from surgery showed 94.4% sensitivity and a positive predictive value of 93.9%. Median diagnostic-time of single-biopsy was 13 days. Conclusion: The performance of SCB in Denmark is comparable to international studies regarding the diagnostic value of malignant SCB. The study indicates that DKBI-RADS classifications are not used consistently regarding micro-calcifications selected in screening-mammographies. Diagnostic delay is acceptable, subject to EUSOMA specifications, regarding single-biopsy.
Cite this paper: Redsted, S. , Nguyen, Q. , Christensen, R. , Myrtue, G. , Caterino, T. and Lautrup, M. (2018) Stereotactic Core Biopsy Following Screening Mammography: A Danish Retrospective National Cohort Study. International Journal of Clinical Medicine, 9, 341-355. doi: 10.4236/ijcm.2018.95030.
References

[1]   Danish Breast Cancer Cooperative Group. DBCG.dk.
http://www.dbcg.dk/

[2]   Cancer. Cancer.dk.
http://www.cancer.dk/

[3]   Lynge, E., Bak, M., Euler-Chelpin, M., Kroman, N., Lernevall, A., Mogensen, N.B., Schwartz, W., Wronecki, A.J. and Vejborg, I. (2017) Outcome of Breast Cancer Screening in Denmark. BMC Cancer, 17, 897.

[4]   Liberman, L., Gougoutas, C.A., Zakowski, M.F., et al. (2001) Calcifications Highly Suggestive of Malignancy: Comparison of Breast Biopsy Methods. American Journal of Roentgenology, 177, 165-172.

[5]   Philpotts, L.E., Shaheen, N.A., Carter, D., Lange, R.C. and Lee, C.H. (1999) Comparison of Rebiopsy Rates after Sterotactic Core Needle Biopsy of the Breast with 11-Gauge Vacuum Suction Probe versus 14-Gauge Needle and Automatic Gun. American Journal of Roentgenology, 172, 683-687.

[6]   Maxwell, A.J., Ridley, N.T., Rubin, G., Gilbert, F.J. and Michell, M.S. (2009) The Royal College of Radiologists Breast Group Breast Imaging Classification. Clinical Radiology, 64, 624-627.
https://doi.org/10.1016/j.crad.2009.01.010

[7]   Radiologi, Svensk Förening för Medicinsk. Klassifikation av Radiologiska Bilddiagnostiska Fynd i Bröst. Svensk Förening för Medicinsk Radiologi.
http://www.sfmr.se/sidor/sfrb---rekommendationer/

[8]   Bell, D., Weerakkody, Y., et al. (2016) Breast Imaging-Reporting and Data System (BI-RADS). Radiopedia.org.
https://radiopaedia.org/articles/breast-imaging-reporting-and-data-system-birads

[9]   Liberman, L. (2002) Percutaneous Image-Guided Core Breast Biopsy. Radiologic Clinics of North America, 40, 483-500.

[10]   Sharma, E.S. (2014) Estimation for Lesion Depth in Mammograms Using Stereotactic Biopsy. International Journal of Advanced Research in Computer Science and Software Engineering, 4, No. 2.
http://ijarcsse.com/Before_August_2017/docs/papers/Volume_4/2_February2014/V4I2-0181.pdf

[11]   Nakamura, Y., Urashima, M., Mutsuura, M., Nishihara, R., Itoh, A., Kagemoto, M. and Hagiki, K. (2010) Stereotactic Directional Vacuum-Assisted Breast Biopsy using Lateral Approach. Breast Cancer, 17, 286-289.

[12]   Sim, Y.T., Litherland, J., Lindsay, E., Hendry, P., Brauer, K., Dobson, H., Cordiner, C., Galiardi, T. and Smart, L. (2015) Upgrade of Ductal Carcinoma in Situ on Core Biopsies to Invasive Disease at Final Surgery: A Retrospective Review across the Scottish Breast Screening Programme. Clinical Radiology, 70, 502-506.

[13]   Sinn, H.P. and Kreipe, H. (2013) A Brief Overview of the WHO Classification of Breast Tumors. Breast Care, 8, 149-154.

[14]   WHO (2012) Classification of Tumors of the Breast. 4th Edition.

[15]   Kettritz, U., Morack, G. and Decker, T. (2005) Stereotactic Vacuum-Assisted Breast Biopsies in 500 Women with Microcalcifications: Radiological and Pathological Correlations. European Journal of Radiology, 55, 270-276.

[16]   Kettritz, U., Rotter, K., Schreer, I., Murauer, M., Schulz-Wendtland, R., Peter, D. and Heywang-Köhbrunner, S.H. (2004) Stereotactic Vacuum-Assisted Breast Biopsy in 2874 Patients—A Multicenter Study. Cancer, 100, 245-251.
https://doi.org/10.1002/cncr.11887

[17]   Uematsu, T., Kasami, M. and Yuen, S. (2008) Usefulness and Limitations of the Japan Mammography Guidelines for the Categorization of Microcalcifications. Breast Cancer, 15, 291-297.
https://doi.org/10.1007/s12282-008-0033-4

[18]   Liberman, L., Abrahamson, A.F., Squires, F.B., Morris, E.A. and Dershaw, D.D. (1998) The Breast Imaging Reporting and Data System: Positive Predictive Value of Mammographic Features and Final Assessment Categories. American Journal of Roentgenology, 171, 35-40.

[19]   Mendez, A., Cabanillas, F., Echenique, M., et al. (2004) Mammographic Features and Correlation with Biopsy Findings using 11-Gauge Stereotactic Vacuum-Assisted Breast Biopsy (SVABB). Annals of Oncology, 15, 450-454.

[20]   Sanders, M.A., Roland, L. and Sahoo, S. (2010) Clinical Implications of Subcategorizing BI-RADS 4 Breast Lesions Associated with Microcalcification: A Radiology-Pathology Correlation Study. The Breast Journal, 16, 28-31.

[21]   Steger, H.E. and Pape, C. (1972) Beitrag zur Feinstruktur der sogenannten Mikrokalzifikation in Mamma tumoren. Zentralblatt Fur Allgemeine Pathologie, 115, 106.

[22]   EUSOMA (European Society of Breast Cancer Specialists).
https://www.eusoma.org/

[23]   Chang, J.H., Vines, E., Bertsch, H., et al. (2001) The Impact of a Multidisciplinary Breast Cancer Center on Recommendations for Patient Management: The University of Pennsylvania Experience. Cancer, 91, 1231-1237.
https://www.ncbi.nlm.nih.gov/pubmed/11283921

[24]   Wiley, E.L. and Keh, P. (1999) Diagnostic Discrepancies in Breast Specimens Subjected to Gross Reexamination. The American Journal of Surgical Pathology, 23, 876-879.
https://www.ncbi.nlm.nih.gov/pubmed/10435555

[25]   Hansen, R.P., Vested, P., et al. (2011) Time Intervals from First Symptoms to Treatment of Cancer: A Cohort Study of 2212 Newly Diagnosed Cancer Patients. BMC Health Services Research, 11, 284.

 
 
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