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| |  Routine Review of Percutaneous Breast Biopsy Specimens Is Essential: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 7, 2010 -- Researchers are calling for the systematic review of percutaneous breast biopsy results and their corresponding imaging studies, according to a presentation here at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO). Brian K. Bednarski, MD, University of North Carolina, Chapel Hill, North Carolina, said on March 6 that such a review is important to ensure accuracy and identify patients who may need a surgical biopsy. The investigators reviewed data in all women who underwent percutaneous breast biopsy at their institution during a 12-month period. “Percutaneous breast biopsy is the standard of care for the diagnosis of pathological lesions detected on breast imaging,” Dr. Bednarski observed. Reported false-negative rates vary from 0.3% to 8.2%, and one way to limit the impact of false-negatives is the systematic review of pathology results and radiological features to ensure correlation, he said. At the University of North Carolina, all percutaneous breast biopsies are reviewed systematically by members of the radiology division’s breast-imaging section. Concordant biopsies require no further investigation, and discordant biopsies are recommended for surgical excision. Little is known, however, about the impact of this practice on patient outcome, according to Dr. Bednarski. In the current study, clinical, radiographic, and pathological data were acquired from the patient digital medical records. Overall, 577 biopsies were included in the analysis of which 143 (24.7%) were malignant and 434 (75.2%) were benign. Of the benign lesions, 38 (8.7%) were deemed discordant. Twenty-nine surgical biopsies were subsequently performed, and 8 (27.5%) showed either atypical hyperplasia or a malignancy. Further analysis indicated that patients aged >50 years and patients with a history of breast biopsies or with a family history of breast cancer are at greater risk for discordance. Overall, the data show a high rate of discordance between pathological and radiological findings after percutaneous breast biopsy along with a high rate of changes in clinical management in patients deemed to be discordant who then had a surgical biopsy. Accordingly, a routine, systematic review of percutaneous breast biopsy specimens and their corresponding imagining studies is important, Dr. Bednarski concluded. [Presentation title: Clinical Utility of Routine Radiologic-Pathologic Correlation of Percutaneous Breast Biopsy Specimens. Abstract P57]
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