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Myers KS, Oluyemi ET, Mullen LA, Panigrahi B, Di Carlo PA, Nguyen DL, Ambinder EB. Outcomes of Canceled Tomosynthesis-Guided Biopsy of Architectural Distortion Due to Nonvisualization. JOURNAL OF BREAST IMAGING 2022; 4:400-407. [DOI: 10.1093/jbi/wbac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Architectural distortion without a sonographic correlate is an indication for digital breast tomosynthesis–guided vacuum-assisted biopsy (DBT-VAB). However, when the finding is not visualized on the day of biopsy, the procedure is canceled. This study reports the outcomes of canceled DBT-VAB of architectural distortion due to nonvisualization.
Methods
In this IRB-approved retrospective study, chart review was performed to identify DBT-VABs of architectural distortion at our institution between June 1, 2017, and November 1, 2020, that were canceled because of nonvisualization at the time of biopsy. Cases without follow-up imaging were excluded. Statistical analysis, including the frequency of cases yielding malignancy by the end of the study period, was performed.
Results
In total, 7.2% (39/544) of architectural distortions recommended for biopsy during the study period were canceled because of nonvisualization, 30 of which had follow-up imaging and were included in the study. Mean patient age was 56 years (standard deviation [SD], 9.6 years) and mean follow-up time was 26.7 months (SD, 11.2 months; range, 8.4–50.9 months). During the follow-up period, 16.7% (5/30) underwent repeat biopsy attempt, with one malignant result (1/30, 3.3%; SD, 18%; 95% confidence interval: 0.6%–16.7%). In total, 86.7% (26/30) of cases were declared benign during the follow-up period and 10% (3/30) remained stable with a BI-RADS 3 assessment category.
Conclusion
During available follow-up, there was a low likelihood that distortions not visualized at the time of DBT-VAB represented malignancy (3.3%, 1/30). While this low malignancy rate is reassuring, imaging follow-up is warranted.
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Affiliation(s)
- Kelly S Myers
- Johns Hopkins School of Medicine, Department of Radiology , Baltimore, MD , USA
| | - Eniola T Oluyemi
- Johns Hopkins School of Medicine, Department of Radiology , Baltimore, MD , USA
| | - Lisa A Mullen
- Johns Hopkins School of Medicine, Department of Radiology , Baltimore, MD , USA
| | - Babita Panigrahi
- Johns Hopkins School of Medicine, Department of Radiology , Baltimore, MD , USA
| | - Philip A Di Carlo
- Johns Hopkins School of Medicine, Department of Radiology , Baltimore, MD , USA
| | - Derek L Nguyen
- Johns Hopkins School of Medicine, Department of Radiology , Baltimore, MD , USA
| | - Emily B Ambinder
- Johns Hopkins School of Medicine, Department of Radiology , Baltimore, MD , USA
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