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Breast Imaging

E2313. Outcomes From Stereotactic Core Needle Biopsy of Noncalcified Abnormalities

Park J1,  Tanimoto A2,  Wang L.2 1. New York University, New York, NY; 2. Northwestern Memorial Hospital, Chicago, IL

Address correspondence to A. Tanimoto (Aki.tanimoto@northwestern.edu)

Objective: To evaluate the pathologic outcomes for stereotactic biopsy of noncalcified abnormalities and examine whether certain mammographic features or patient factors confer an increased probability of malignancy.

Materials and Methods: Under institutional review board approval, a retrospective review of all patients undergoing stereotactic biopsy for noncalcified abnormalities at a single academic center between October 2013 and October 2015 was performed. The proportion of biopsies performed for masses, focal asymmetries, developing asymmetries, asymmetries, and architectural distortion were calculated, in addition to the rate of malignancy for each mammographic finding. Imaging features and patient factors (including family history, personal history, age, and breast density) were also evaluated for correlation with malignancy.

Results: Of 1251 stereotactic biopsies, 94 (7.5%) were performed for noncalcified abnormalities (mass [32%], architectural distortion [22%, 14 cases on 2D and 7 cases on 2D+3D], developing asymmetry [22%], focal asymmetry [19%], asymmetry [3%], and prominent duct [1%]). Overall, pathology findings were malignant in 11% (nine invasive, one dual carcinoma in situ), high risk in 18% (most often radial scar), and benign in 71% (most commonly pseudoangiomatous stromal hyperplasia) of cases. Of the targeted abnormalities, architectural distortion was significantly more likely to yield high-risk or malignant pathology findings compared to other mammographic findings (p < 0.05). Of patient factors, older age was significantly correlated with malignancy (benign vs malignant mean age, 50.3 vs 65.2 years, p < 0.05).

Conclusion: This is one of a few studies that examine the pathologic outcomes of stereotactic biopsy for noncalcified abnormalities. Of the targeted abnormalities, architectural distortion was significantly more likely to yield high-risk or malignant pathology findings compared to other mammographic findings. Given increased utilization of tomosynthesis and increased sensitivity of this modality, particularly for architectural distortion, stereotactic biopsy of noncalcified abnormalities will likely increase in frequency. As such, knowledge of the potential pathologic outcomes for stereotactic biopsy of noncalcified abnormalities is important for appropriate BI-RADS assessment and determination of imaging-pathology concordance.