Analysis of stereotactic biopsies performed on suspicious calcifications identified within 24 months after completion of breast conserving surgery and radiation therapy for early breast cancer: Can biopsy be obviated?

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Abstract

Background: To determine the cancer yield of stereotactic biopsy of suspicious calcifications identified within 24 months after breast conservation therapy (BCT). Methods: Retrospective review of stereotactic biopsies performed during 2009–2013 for suspicious calcifications in the ipsilateral breast of patients who completed BCT. Results: 94/2773 (3.4%) had stereotactic biopsies for suspicious calcifications in the ipsilateral breast; 7/94 (7.4%) had DCIS (6) or invasive (1) cancer; 5/7 occurred in the same breast quadrant as the primary. All 7 originally had negative surgical margins (≥2 mm); 6 received whole breast irradiation, and 2 received adjuvant chemotherapy + endocrine therapy. Median time to detection was 11 months (range, 6–20 months). There was a strong association between calcification morphology (particularly pleomorphic) and likelihood of malignancy (p = 0.008). Conclusions: Stereotactic biopsy of calcifications identified within 24 months post-BCT has a 7% cancer yield. Tissue biopsy should be performed rather than imaging followup alone when breast calcifications have suspicious morphology.

Original languageEnglish (US)
Pages (from-to)693-698
Number of pages6
JournalAmerican Journal of Surgery
Volume215
Issue number4
DOIs
StatePublished - Apr 1 2018

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Segmental Mastectomy
Breast
Radiotherapy
Breast Neoplasms
Biopsy
Neoplasms
Carcinoma, Intraductal, Noninfiltrating
Adjuvant Chemotherapy

Keywords

  • Breast cancer
  • Breast conservation
  • Calcifications
  • Mammography
  • Stereotactic biopsy

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Analysis of stereotactic biopsies performed on suspicious calcifications identified within 24 months after completion of breast conserving surgery and radiation therapy for early breast cancer: Can biopsy be obviated?",
abstract = "Background: To determine the cancer yield of stereotactic biopsy of suspicious calcifications identified within 24 months after breast conservation therapy (BCT). Methods: Retrospective review of stereotactic biopsies performed during 2009–2013 for suspicious calcifications in the ipsilateral breast of patients who completed BCT. Results: 94/2773 (3.4{\%}) had stereotactic biopsies for suspicious calcifications in the ipsilateral breast; 7/94 (7.4{\%}) had DCIS (6) or invasive (1) cancer; 5/7 occurred in the same breast quadrant as the primary. All 7 originally had negative surgical margins (≥2 mm); 6 received whole breast irradiation, and 2 received adjuvant chemotherapy + endocrine therapy. Median time to detection was 11 months (range, 6–20 months). There was a strong association between calcification morphology (particularly pleomorphic) and likelihood of malignancy (p = 0.008). Conclusions: Stereotactic biopsy of calcifications identified within 24 months post-BCT has a 7{\%} cancer yield. Tissue biopsy should be performed rather than imaging followup alone when breast calcifications have suspicious morphology.",
keywords = "Breast cancer, Breast conservation, Calcifications, Mammography, Stereotactic biopsy",
author = "Candelaria, {Rosalind Pitpitan} and Palita Hansakul and Alastair Thompson and Huong Le-Petross and Vicente Valero and Roland Bassett and Huang, {Monica L.} and Lumarie Santiago and Adrada, {Beatriz Elena}",
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TY - JOUR

T1 - Analysis of stereotactic biopsies performed on suspicious calcifications identified within 24 months after completion of breast conserving surgery and radiation therapy for early breast cancer

T2 - Can biopsy be obviated?

AU - Candelaria, Rosalind Pitpitan

AU - Hansakul, Palita

AU - Thompson, Alastair

AU - Le-Petross, Huong

AU - Valero, Vicente

AU - Bassett, Roland

AU - Huang, Monica L.

AU - Santiago, Lumarie

AU - Adrada, Beatriz Elena

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background: To determine the cancer yield of stereotactic biopsy of suspicious calcifications identified within 24 months after breast conservation therapy (BCT). Methods: Retrospective review of stereotactic biopsies performed during 2009–2013 for suspicious calcifications in the ipsilateral breast of patients who completed BCT. Results: 94/2773 (3.4%) had stereotactic biopsies for suspicious calcifications in the ipsilateral breast; 7/94 (7.4%) had DCIS (6) or invasive (1) cancer; 5/7 occurred in the same breast quadrant as the primary. All 7 originally had negative surgical margins (≥2 mm); 6 received whole breast irradiation, and 2 received adjuvant chemotherapy + endocrine therapy. Median time to detection was 11 months (range, 6–20 months). There was a strong association between calcification morphology (particularly pleomorphic) and likelihood of malignancy (p = 0.008). Conclusions: Stereotactic biopsy of calcifications identified within 24 months post-BCT has a 7% cancer yield. Tissue biopsy should be performed rather than imaging followup alone when breast calcifications have suspicious morphology.

AB - Background: To determine the cancer yield of stereotactic biopsy of suspicious calcifications identified within 24 months after breast conservation therapy (BCT). Methods: Retrospective review of stereotactic biopsies performed during 2009–2013 for suspicious calcifications in the ipsilateral breast of patients who completed BCT. Results: 94/2773 (3.4%) had stereotactic biopsies for suspicious calcifications in the ipsilateral breast; 7/94 (7.4%) had DCIS (6) or invasive (1) cancer; 5/7 occurred in the same breast quadrant as the primary. All 7 originally had negative surgical margins (≥2 mm); 6 received whole breast irradiation, and 2 received adjuvant chemotherapy + endocrine therapy. Median time to detection was 11 months (range, 6–20 months). There was a strong association between calcification morphology (particularly pleomorphic) and likelihood of malignancy (p = 0.008). Conclusions: Stereotactic biopsy of calcifications identified within 24 months post-BCT has a 7% cancer yield. Tissue biopsy should be performed rather than imaging followup alone when breast calcifications have suspicious morphology.

KW - Breast cancer

KW - Breast conservation

KW - Calcifications

KW - Mammography

KW - Stereotactic biopsy

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