A Comprehensive Assessment of Radial Scars on Core Needle Biopsy in Patients with or without Breast Cancer: Upgrade Rate and Implications on Management

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2024-06-01 DOI:10.1016/j.clbc.2024.01.020

Arith Reyes , Luona Sun , Richard Ha , Elise Desperito , Marc Brown , Mark A. Francescone , Stacy Ugras , Lisa Wiechmann , Roshni Rao , Bret Taback

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引用次数: 0

Abstract

Background

Radial scars/radial sclerosing lesions (RS) are benign breast lesions identified on core needle biopsy (CNB) which can upgrade to malignancy at excision. There is limited data on RS detection and upgrade rates with more sensitive imaging such as magnetic resonance imaging (MRI) and none during their detection for breast cancer workup and its implication on patient treatment decisions.

Methods

A retrospective institutional study of RS diagnosed on CNB between January 2008 and December 2017 was conducted. Clinicopathologic and radiologic features of RS, patient treatment decisions, upgrade rates and long-term follow-up were examined.

Results

We identified 133 patients with RS on CNB, of whom 106 opted for surgery for an upgrade rate to malignancy of 1.9%, 2 patients. Radial scar was diagnosed on mammogram in 60%, MRI in 25% and ultrasound in 15% of patients. In this cohort, 32 patients had their RS detected during breast cancer workup (coexistent group) and they were more likely to have their radial scar detected by MRI (60% vs. 14%, P < .001) and undergo more extensive surgery (94% vs. 75%, P = .02). Among the 27 patients electing observation of their RS, only one (3.7%) developed breast cancer.

Conclusions

Our results show an extremely low upgrade rate to malignancy of RS, regardless if there is coexisting breast cancer elsewhere. Despite this, RS still prompted more extensive surgical excisions. The findings do not support excision of RS even among breast cancer patients when identified at a separate site from their cancer.

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全面评估乳腺癌患者或非乳腺癌患者核心针活检的桡骨疤痕：升级率及其对管理的影响

背景径向疤痕/径向硬化性病变（RS）是核心针活检（CNB）发现的乳腺良性病变，切除时可升级为恶性病变。2008年1月至2017年12月期间，对经CNB确诊的RS进行了回顾性机构研究。结果我们发现了 133 例 CNB 诊断为 RS 的患者，其中 106 例选择了手术治疗，恶性肿瘤升级率为 1.9%，2 例患者选择了手术治疗。60%的患者通过乳房X光检查、25%的患者通过核磁共振成像、15%的患者通过超声波检查确诊为桡骨疤痕。在这组患者中，有 32 名患者在乳腺癌检查过程中发现了桡骨疤痕（共存组），他们更有可能通过核磁共振检查发现桡骨疤痕（60% 对 14%，p < 0.001），并接受更广泛的手术（94% 对 75%，p = 0.02）。结论我们的研究结果表明，无论是否合并其他部位的乳腺癌，RS恶变率都非常低。尽管如此，RS 仍需要进行更广泛的手术切除。研究结果并不支持乳腺癌患者切除RS，即使RS是在乳腺癌以外的其他部位发现的。我们对当代队列中放射状瘢痕的识别及其影响进行了全面评估。我们的研究表明，即使在乳腺癌检查过程中被发现，其恶性程度也很低，但在这一患者群体中，进行更广泛手术的可能性仍然增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.