Flat Epithelial Atypia: Comparison Between 9-Gauge and 11-Gauge Devices |
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| Authors: | Alessandro Villa Fabio Chiesa Tiberio Massa Daniele Friedman Giuseppe Canavese Paola Baccini Massimo Calabrese Alberto Tagliafico |
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| Affiliation: | 1. Department of Radiology, “San Bartolomeo di Sarzana,” Sarzana, La Spezia, Italy;2. Department of Breast Radiology, IRCCS AOU San Martino-IST, Genova, Italy;3. Department of Breast Surgery, IRCCS AOU San Martino-IST, Genova, Italy;4. Department of Pathological Anatomy, IRCCS AOU San Martino-IST, Genova, Italy;5. Department of Experimental Medicine (DIMES), University of Genova, Genova, Italy;1. Department of Radiation Oncology, Rhode Island Hospital, Brown Alpert Medical School, Providence, RI;2. Department of Radiation Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA;1. Department of Medical Oncology, St. Luke''s International Hospital, Tokyo, Japan;2. Department of Breast Surgical Oncology, St. Luke''s International Hospital, Tokyo, Japan;3. Center for Clinical Epidemiology, St. Luke''s Life Science Institute, Tokyo, Japan;4. Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA;5. Breast Medical Oncology, Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX;1. Department of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX;2. Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX;3. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX;4. Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX;1. Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria;2. Department of Clinical Pathology, Medical University of Vienna, Austria;1. Department of Radiology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Institut Universitaire de Cancérologie, Université Pierre et Marie Curie, France;2. Department of Radiology, Institut Curie, Paris, France;3. Department of Radiology, Centre de référence et d''investigation des maladies du sein (CRID), Hôtel Dieu, Centre Hospitalier Universitaire de Montréal (CHUM), Canada |
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| Abstract: | BackgroundThis study aimed to establish if women with a diagnosis of flat epithelial atypia (FEA) without residual microcalcifications at stereotactic vacuum-assisted breast biopsy (VABB) could be managed with mammographic follow-up (FU) instead of surgery and to compare 9-gauge and 11-gauge devices.Patients and MethodsFrom October 2003 to January 2011, 2382 VABB procedures were performed (1373 with 11-gauge and 1009 with 9-gauge). We found 121 cases of pure FEA that were surgically treated: 57 with a 9-gauge device (group 1) and 64 with an 11-gauge device (group 2). The underestimation rate (UR) of malignancy for patients without and those with residual microcalcifications for each VABB device was calculated. Differences between groups were analyzed with the Fischer exact test.ResultsThe overall UR of FEA was 4% (2 of 57) with the 9-gauge device and 8% (5 of 64) with the 11-gauge device. With a 9-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 46), and the UR for patients with residual microcalcifications was 18% (2 of 11). With an 11-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 39), the UR for patients with residual microcalcifications at post-biopsy mammograms was 16% (5 of 25). With a 9-gauge device, 80% (46 of 57) of patients did not have residual microcalcifications after VABB. With an 11-gauge device, 60% (39 of 64) of patients had no residual microcalcifications after VABB. Differences between the 9-gauge and 11-gauge devices were statistically significant (P < .05).ConclusionWomen with FEA without residual microcalcifications after VABB can be managed conservatively. Nine-gauge VABB is associated with a lower percentage of residual microcalcifications compared with an 11-gauge device, but it is safe to follow patients with FEA if all calcifications are removed with the core biopsy. |
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| Keywords: | Breast cancer Flat epithelial Atypia Underestimation rate vacuum-assisted breast biopsy |
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