Christopher Edmund Comstock MD, Presenter: Speaker, Suros Surgical Systems, Inc Speakers Bureau, Johnson & Johnson (Ethicon Endo-Surgery, Inc)

Jilbert Eradat BS, Abstract Co-Author: Nothing to Disclose

Michael Simca Middleton PhD, MD, Abstract Co-Author: Nothing to Disclose

To evaluate the rate at which lobular neoplasia diagnosed on vacuum-assisted core needle biopsy of the breast is upgraded to carcinoma upon surgical excision.

A retrospective review was performed of vacuum-assisted core needle breast biopsies from August 2000 through July 2004. Biopsies were performed using either stereotactic, ultrasound or MRI guidance. Vacuum core needle sizes were: Stereotactic - 11GA, Ultrasound - 11 and 8GA, MRI - 12GA. Cases in which the pathology yielded lobular neoplasia (Lobular hyperplasia, atypical lobular hyperplasia and lobular carcinoma in situ) were reviewed. Core biopsy results were compared to pathology at excision.

16 patients had a diagnosis of lobular neoplasia at vacuum-assisted core needle biopsy of the breast. Surgical excison pathology was available on 11 patients. Four ultrasound, 1 MRI and 6 stereotactic biopsies were performed. Two of the 11 patients (18%) were found to have carcinoma at surgical excision. The cancers found were: 1 invasive lobular and 1 mixed invasive ductal and lobular. Both cancers found were in patients who underwent stereotactic biopsy.

Although further data is needed, surgical excision should be considered when a diagnosis of lobular neoplasia is obtained at vacuum-assisted core biopsy of the breast.

Relvant to the management of patients undergoing vacuum-assisted core needle biopsy of the breast.

Comstock, C, Eradat, J, Middleton, M, Upgrade Rates of Lobular Neoplasia Found at Vacuum-assisted Core Needle Biopsy of the Breast.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4442460.html