Avoidable and Unavoidable Repeat Breast Core Needle Biopsies

Xiaoqin Wang (1), Fara Shikoh (2), Aurela Clark (3), Mauro Hanaoka (4)
(1) Department of Radiology, University of Kentucky, Lexington, Kentucky USA; Markey Cancer Center, University of Kentucky, Lexington, Kentucky USA, United States,
(2) Department of Radiology, University of Kentucky, Lexington, Kentucky USA, Markey Cancer Center, University of Kentucky, Lexington, Kentucky USA, United States,
(3) Department of Radiology, University of Kentucky, Lexington, Kentucky USA, Markey Cancer Center, University of Kentucky, Lexington, Kentucky USA, United States,
(4) Department of Radiology, University of Kentucky, Lexington, Kentucky USA, United States

Abstract

Background: Breast core needle biopsies are not perfect and could miss cancer. The need for a repeat breast core biopsy is not uncommon and can occur for a multitude of reasons. Radiologists should carefully correlate the pathology results with imaging features after each breast biopsy and must recognize why certain core biopsies must be repeated to avoid missed or delayed cancer diagnosis. In this review, we discuss the main reasons for repeat core biopsies via case presentation with radiological images and pathological correlation. This review will help multidisciplinary breast care team recognize when to repeat a biopsy to reduce false negatives and will also familiarize radiologists with techniques for improving initial biopsy success.
Methods: We performed literature and chart reviews of cases at our institution between January 2015 and December 2019.
Results: While some repeat biopsies are inevitable, most can be avoided with careful pre-biopsy planning, adequate sampling techniques, and proper radiological-pathological correlation.
Conclusion: Repeat breast core needle biopsies occur due to multiple avoidable and unavoidable radiological or pathological issues. It is imperative for both multidisciplinary breast care team and radiologists to recognize when to repeat a biopsy to reduce false negative or delayed cancer diagnosis via careful reviews before and after the procedure and adequate radiological and pathological correlation.

Full text article

Generated from XML file

References

Elmore JG, Longton GM, Carney PA, Geller BM, Onega T, Tosteson AN, et al. Diagnostic concordance among pathologists interpreting breast biopsy specimens. JAMA. 2015;313(11):1122-32. doi: 10.1001/jama.2015.1405.

Bruening W, Fontanarosa J, Tipton K, Treadwell JR, Launders J, Schoelles K. Systematic review: comparative effectiveness of core-needle and open surgical biopsy to diagnose breast lesions. Ann Intern Med. 2010;152(4):238-46. doi: 10.7326/0003-4819-152-1-201001050-00190.

Dillon MF, Hill AD, Quinn CM, O'Doherty A, McDermott EW, O'Higgins N. The accuracy of ultrasound, stereotactic, and clinical core biopsies in the diagnosis of breast cancer, with an analysis of false-negative cases. Ann Surg. 2005;242(5):701-7. doi: 10.1097/01.sla.0000186186.05971.e0.

Pijnappel RM, van den Donk M, Holland R, Mali WP, Peterse JL, Hendriks JH, et al. Diagnostic accuracy for different strategies of image-guided breast intervention in cases of nonpalpable breast lesions. Br J Cancer. 2004;90(3):595-600. doi: 10.1038/sj.bjc.6601559.

Youk JH, Kim EK, Kim MJ, Lee JY, Oh KK. Missed breast cancers at US-guided core needle biopsy: how to reduce them. Radiographics. 2007;27(1):79-94. doi: 10.1148/rg.271065029.

Pfarl G, Helbich TH, Riedl CC, Wagner T, Gnant M, Rudas M, et al. Stereotactic 11-gauge vacuum-assisted breast biopsy: a validation study. AJR Am J Roentgenol. 2002;179(6):1503-7. doi: 10.2214/ajr.179.6.1791503.

Pritzker KPH, Nieminen HJ. Needle Biopsy Adequacy in the Era of Precision Medicine and Value-Based Health Care. Arch Pathol Lab Med. 2019;143(11):1399-415. doi: 10.5858/arpa.2018-0463-RA.

Mahoney MC, Newell MS. Breast intervention: how I do it. Radiology. 2013;268(1):12-24. doi: 10.1148/radiol.13120985.

Meissnitzer M, Dershaw DD, Lee CH, Morris EA. Targeted ultrasound of the breast in women with abnormal MRI findings for whom biopsy has been recommended. AJR Am J Roentgenol. 2009;193(4):1025-9. doi: 10.2214/AJR.09.2480.

Boba M, Koltun U, Bobek-Billewicz B, Chmielik E, Eksner B, Olejnik T. False-negative results of breast core needle biopsies - retrospective analysis of 988 biopsies. Pol J Radiol. 2011;76(1):25-9. doi: Not Available.

Bonnett M, Wallis T, Rossmann M, Pernick NL, Bouwman D, Carolin KA, et al. Histopathologic analysis of atypical lesions in image-guided core breast biopsies. Mod Pathol. 2003;16(2):154-60. doi: 10.1097/01.MP.0000052375.72841.E2.

Stein MA, Karlan MS. Calcifications in breast biopsy specimens: discrepancies in radiologic-pathologic identification. Radiology. 1991;179(1):111-4. doi: 10.1148/radiology.179.1.2006260.

Friedman PD, Sanders LM, Menendez C, Kalisher L, Petrillo G. Retrieval of lost microcalcifications during stereotactic vacuum-assisted core biopsy. AJR Am J Roentgenol. 2003;180(1):275-80. doi: 10.2214/ajr. 180.1.1800275.

Izumori A, Kokubu Y, Sato K, Gomi N, Morizono H, Sakai T, et al. Usefulness of second-look ultrasonography using anatomical breast structures as indicators for magnetic resonance imaging-detected breast abnormalities. Breast Cancer. 2020;27(1):129-39. doi: 10.1007/s12282-019-01003-z.

Park VY, Kim MJ, Kim EK, Moon HJ. Second-look US: how to find breast lesions with a suspicious MR imaging appearance. Radiographics. 2013;33(5): 1361-75. doi: 10.1148/rg.335125109.

Hayward JH, Ray KM, Wisner DJ, Joe BN. Follow-up outcomes after benign concordant MRI-guided breast biopsy. Clin Imaging. 2016;40(5):1034-9. doi: 10.1016/j.clinimag.2016.06.005.

Patel BK, Chen T, Newell M, Kosiorek HE, Loving V, D'Orsi C. Surveillance Imaging After MRI-Guided Benign Breast Biopsies. J Am Coll Radiol. 2019;16(7):936-9. doi: 10.1016/j.jacr.2018.12.001.

Authors

Xiaoqin Wang
Fara Shikoh
Aurela Clark
Mauro Hanaoka
hanaoka@uky.edu (Primary Contact)
Author Biographies

Xiaoqin Wang, Department of Radiology, University of Kentucky, Lexington, Kentucky USA; Markey Cancer Center, University of Kentucky, Lexington, Kentucky USA

Assistant Professor of Radiology, Department of Radiology, University of Kentucky, Lexington, Kentucky USA; Markey Cancer Center, University of Kentucky, Lexington, Kentucky USA  

Fara Shikoh, Department of Radiology, University of Kentucky, Lexington, Kentucky USA, Markey Cancer Center, University of Kentucky, Lexington, Kentucky USA

Assistant Professor, Department of Radiology, University of Kentucky, Lexington, Kentucky USA

Mauro Hanaoka, Department of Radiology, University of Kentucky, Lexington, Kentucky USA

Resident Physician, Department of Radiology, University of Kentucky, Lexington, Kentucky USA

1.
Wang X, Shikoh F, Clark A, Hanaoka M. Avoidable and Unavoidable Repeat Breast Core Needle Biopsies. Arch Breast Cancer [Internet]. 2022 Jan. 23 [cited 2024 Jul. 16];9(1):32-9. Available from: https://archbreastcancer.com/index.php/abc/article/view/458

Article Details

Similar Articles

You may also start an advanced similarity search for this article.