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JN : J Med Assoc Thai. 2005 Apr;88(4):460-6.
TI : Breast cancer underestimation rate of atypical ductal hyperplasia diagnosed by core-needle biopsy under imaging guidance.
AU : Wiratkapun C, Wibulpholprasert B, Lertsithichai P, Pulpinyo K, Wongwaisayawan S.
EN-AB: OBJECTIVE: To evaluate breast cancer underestimation rate of atypical ductal hyperplasia (ADH) diagnosed by core-needle biopsy (CNB) under imaging guidance in Ramathibodi Hospital and to determine the difference between the malignant and benign groups in terms of clinical and imaging characteristics. MATERIAL AND METHOD: The pathological records of 1521 patients who underwent CNB under imaging guidance were reviewed. Thirty-nine patients diagnosed with ADH were enrolled into the present study. Clinical data, imaging features, biopsy technique and result of excisional biopsy as well as follow-up data were retrospectively reviewed. RESULTS: Of 39 ADH cases, eight (20.5%) were found to have malignancy on subsequent excisional biopsy. The majority of these were ductal carcinoma in situ (DCIS) (62.5%). Lesion categorized as category 5 according to BI-RADS (Breast imaging reporting and data system) was the only feature which was statistically different between the benign and malignant groups. No statistically significant difference was found between the benign and malignant groups in terms of age, personal and family history of breast cancer, clinical finding, mammographic lesion type, size of lesion, image-guided technique and percentage of lesion removal. CONCLUSION: The underestimation rate of ADH in the present study was comparable to other studies. The finding of Bl-RADS category 5 in patients with ADH diagnosed from CNB is a strong indication for subsequent excisional biopsy. (NO 16146248)
JN : J Med Assoc Thai. 2005 Mar;88(3):350-7.
TI : Nondiagnostic core needle biopsy of the breast under imaging guidance: result of rebiopsy.
AU : Wiratkapun C, Wibulpholprasert B, Wongwaisayawan S, Pulpinyo K.
EN-AB: OBJECTIVE: To determine the rate and the clinical application of recommendation for repeat biopsy after core needle biopsy (CNB) under imaging guidance and to determine the result of rebiopsy. MATERIAL AND METHOD: A retrospective review was performed in 1,306 consecutive women who underwent core needle biopsy under imaging guidance at the breast diagnostic center, the Faculty of Medicine, Ramathibodi Hospital from October 1997 to March 2004. RESULTS: Among 1,306 patients, there were 44 patients (3.37%) who had undergone rebiopsy. The three most common reasons for recommendation of rebiopsy were discordant imaging and pathology, atypical ductal hyperplasia and inadequate specimen. The authors found 12 malignancies subsequently found in rebiopsy (27.3%). The most common reason for rebiopsy in this group was inadequate specimen. CONCLUSION: Core needle biopsy under imaging guidance is a minimally invasive diagnostic tool and promises high accuracy and reliability. However, some patients need rebiopsy to exclude hidden malignancy. The cooperation between the radiologists, surgeons and pathologists are prudent for giving the best care to the patients. (NO 15962643)
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