Anna Linda MD, Presenter: Nothing to Disclose

Piernicola Machin, Abstract Co-Author: Nothing to Disclose

Elena Vianello MD, Abstract Co-Author: Nothing to Disclose

Anna Dal Col, Abstract Co-Author: Nothing to Disclose

Massimo Bazzocchi MD, Abstract Co-Author: Nothing to Disclose

Chiara Zuiani MD, Abstract Co-Author: Nothing to Disclose

1) to evaluate the underestimation rate of percutaneous biopsy and 2) to identify mammographic and sonographic features able to predict the presence of malignancy, in case of radial scars diagnosed at percutaneous biopsy.

The records of 4458 consecutive imaging-guided breast biopsies performed between January 2000 and May 2008 were retrospectively reviewed. Sixty-two radial scars without atypia diagnosed at sonographically-guided (n=43) or stereotactically-guided (n=19) biopsy and subsequently surgically excised were included in the study. For each lesion, images were reviewed and mammographic and sonographic features were recorded according to the BI-RADS lexicon and assessment categories. The underestimation rate of malignancy of percutaneous biopsy was calculated according to the results of surgical excision. Differences of mammographic and sonographic features between radial scars eventually proven to contain malignancy and benign radial scars were evaluated using the Fisher’s exact test.

The results of surgical excision were malignancy in 5 cases. Overall underestimation rate of malignancy was 8%, being 9% (4/43) for sonographic-guided 14-gauge biopsies and 5% (1/19) for stereotactic-guided 11-gauge vacuum-assisted biopsies (p=1.000). Mammographic and sonographic features were not significantly different between radial scars containing malignancy and benign radial scars.

In our series, 1) percutaneous diagnosis of a radial scar did not exclude associated malignancy at subsequent surgical excision, and 2) mammographic and sonographic features of a lesion diagnosed as a radial scar at percutaneous image-guided biopsy did not predict which lesions would have associated malignancy at subsequent surgical excision.

Surgical excision is required for lesions yielding radial scars at percutaneous biopsy, regardless of their mammographic and sonographic appearance.

Linda, A, Machin, P, Vianello, E, Dal Col, A, Bazzocchi, M, Zuiani, C, Radial Scars Diagnosed at Percutaneous Needle Biopsy: How Often is Associated Malignancy Found at Subsequent Surgical Excision, and do Mammography and Sonography Predict which Lesions are Malignant?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8003274.html