Eric Stephen Rupe, Presenter: Nothing to Disclose

Jocelyn A. Rapelyea MD, Abstract Co-Author: Research Consultant, Siemens AG Consultant, General Electric Company

Megan Lenihan, Abstract Co-Author: Nothing to Disclose

Caitrin M. Coffey BS, Abstract Co-Author: Nothing to Disclose

Jennifer H. Lieberman BA, Abstract Co-Author: Nothing to Disclose

Rachel Frydman Brem MD, Abstract Co-Author: Board of Directors, iCAD, Inc Board of Directors, Dilon Technologies LLC Stock options, iCAD, Inc Stockholder, Dilon Technologies LLC Consultant, U-Systems, Inc Consultant, Dilon Technologies LLC Consultant, Dune Medical Devices Ltd

The aim of this study was to evaluate the outcomes of BSGI-guided biopsy in women with suspicious BSGI findings.

All patients who underwent BSGI-guided biopsy between January 1, 2011 and October 9, 2013 were retrospectively reviewed. 38 women (age 39 to 79) had 40 BSGI-guided biopsies, all of whom were included. Patients who had abnormal BSGI findings in whom a directed ultrasound or directed re-evaluation of the mammogram did not demonstrate a targetable finding underwent BSGI-guided Gamma biopsy. 

Of the 41 attempted biopsies, one was aborted due to vasovagal reaction, 40 (97.6%) were technically successful. In these there were no complications. Of the biopsies performed, pathology demonstrated 5 invasive ductal carcinoma (12.5%) and 1 DCIS (2.5%). High risk lesions included 1 LCIS (2.5%), 3 ADH (7.5%), 2 ALH (5%), and 1 flat epithelial atypia (2.5%). Of these high-risk lesions, 2 cases of ADH were upgraded to DCIS at surgery, for an overall cancer rate of 20% (5 IDC and 3 DCIS) and 15% high-risk lesions (6 LCIS, ADH, ALH, or flat epithelial atypia). Other pathologies include 9 usual ductal hyperplasia (22.5%), 7 fibrocystic changes (17.5%), 7 benign breast tissue (17.5%), and 2 adenosis (5%). 

Of the 38 women with 40 suspicious BSGI findings not visible by mammography or ultrasound, BSGI-guided biopsy demonstrated 8 cancers (20%), 5 invasive and 3 DCIS. There were 6 cases of atypia (15%) for a total of 14 out of 40 (35%) cancer or high risk lesions.  

When a lesion is visible by BSGI, and not by mammography or ultrasound, our findings support BSGI-guided biopsy as a reasonable and accurate approach to biopsy the lesion. Our results compare favorably to those reported for MRI guided biopsy.

Rupe, E, Rapelyea, J, Lenihan, M, Coffey, C, Lieberman, J, Brem, R, Breast-Specific Gamma Imaging (BSGI)-guided biopsy for the Diagnosis of Breast Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006247.html