Performance and role of the breast lesion excision system (BLES) in small clusters of suspicious microcalcifications

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• 作者：Scaperrotta Gianfranco^a ; ^{gianfranco.scaperrotta@istitutotumori.mi.it" class="auth_mail" title="E-mail the corresponding author} ; Ferranti Claudio^a ; Capalbo Emanuela^a ; Paolini Biagio^b ; Marchesini Monica^a ; Suman Laura^a ; Folini Cristina^a ; Mariani Luigi^c ; Panizza Pietro^a
• 关键词：VAB ; vacuum-assisted biopsy ; CNB ; core-needle biopsy ; ALH ; atypical lobular hyperplasia ; LCIS ; lobular carcinoma in situ ; ADH ; atypical ductal hyperplasia ; DCIS ; ductal carcinoma in situ ; BLES ; breast lesion excision system ; BI-RADS ; Breast Imaging Reporting And Data System ; RF ; Radio-Frequency ; H&ndash ; E ; Haematossylin&ndash ; Eosyn ; G1 ; 2 ; 3 ; (Malignancy) Grade 1 ; 2 ; 3 ; HIFU ; high-intensity focused ultrasound
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：85
• 期：1
• 页码：143-149
• 全文大小：1434 K

文摘

To assess the diagnostic performance of the BLES as a biopsy tool in patients with ≤1 cm clusters of BIRADS 4 microcalcifications, in order to possibly avoid surgical excision in selected patients.

Materials

This is a retrospective study of 105 patients undergone to stereotactic breast biopsy with the BLES. It excises a single specimen containing the whole mammographic target, allowing better histological assessment due to preserved architecture.

Results

Our case series consists of 41 carcinomas (39%) and 64 benign lesions (61%). Cancer involved the specimen margins in 20/41 cases (48.8%) or was close to them (≤1 mm) in 14 cases (34.1%); margins were disease-free in only 7 DCIS (17.1%). At subsequent excision of 39/41 malignant cases, underestimation occurred for 5/32 DCIS (15.6%), residual disease was found in 15/39 cancers (38.5%) and no cancer in 19/39 cases (48.7%). For DCIS cases, no residual disease occurred for 66.7% G1–G2 cases and for 35.3% G3 cases (P = 0.1556) as well as in 83.3%, 40.0% and 43.8% cases respectively for negative, close and positive BLES margins (P = 0.2576).

Conclusions

The BLES is a good option for removal of small clusters of breast microcalcifications, giving better histological interpretation, lower underestimation rates and possibly reducing the need of subsequent surgical excision in selected patients.