|
KMID : 1114620090060010019
|
|
Journal of the Korean Society for Breast Screening
2009 Volume.6 No. 1 p.19 ~ p.23
|
|
|
Detection of Residual Breast Carcinoma after Excisional Biopsy
|
|
Park Sang-Hee
Moon Woo-Kyung
Cho Nariya
Chang Jung-Min
Park In-Ae
Noh Dong-Young
|
|
|
Abstract
|
|
|
Purpose: To investigate the role of high-resolution US in revealing the presence and extent of residual tumor within the breast after excisional biopsy and before further surgical intervention.
Materials and Methods: One hundred thirty patients (age range, 26-74 years; median age, 45 years) with breast cancer underwent prospect US examination of the breast using a 10 or 12 MHz transducer for evaluation of residual disease soon after excisional biopsy before further surgery. Time interval between lumpectomy and US ranged 7-64 days (mean, 12 days). Postbiopsy mammograms were obtained in 37 of the 44 patients with calcium-containing lesions. US criteria for residual tumor was indeterminate solid mass and biopsy was performed.
Results: Forty-four patients were treated with breast-conserving surgery and 86 with mastectomy. US depicted 39 (95%) of 41 invasive tumor foci and 24 (50%) of 48 foci of ductal carcinoma in situ (DCIS). Twenty-six false negative cases (20%) were due to 0.5-1.2 cm invasive carcinomas in two patients and DCIS with or without microcalcifications in 24 patients. Five false positive cases (4%) were due to fat necrosis and granulation tissues in two, and fibrocystic changes in three. Postbiopsy mammograms depicted 12 foci of DCIS missed at US. The sensitivity, specificity, and positive and negative predictive values of US for predicting residual tumor was 71% (63/89), 90% (46/51), 93% (63/68) and 64% (46/72). In 17 patients, management was altered from breast conserving surgery to mastectomy based on the basis of US findings.
Conclusion: High-resolution US has a high PPV for predicting residual tumor particularly invasive cancers and within one month after excisional biopsy. False negative findings due to focal residual DCIS remain limitations.
|
|
|
KEYWORD
|
|
|
Breast cancer, Ultrasound, Excisional biopsy
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|