Table 1:
Upgrade rate of FEA at surgical excision in selected series with pathology review
| Study | CNBs with FEA and follow-up EXC |
Rad-Path correlation |
Total Upgrades (%) |
Upgrades to Invasive Carcinoma |
Upgrades to DCIS |
Recommendations |
|---|---|---|---|---|---|---|
| Martel (2007)3 | 19 | No | 7/19 (36%) | 7 | 0 | EXC is not mandatory; close imaging follow up is advised |
| Kunju and Kleer (2007)32 | 12 | No | 3/12 (25%) | 2 | 1 | EXC is warranted |
| Piubello (2009)12 | 20 | Yes | 0/20 (0%) | 0 | 0 | EXC is not mandatory; close imaging follow up is advised |
| Lavoué (2011)33 | 60 | Yes | 8/60 (13%) | 2 | 6 | EXC is warranted |
| Uzoaru (2012)17 | 95 | No | 3/95 (3%) | 2 | 1 | EXC is not mandatory; close imaging follow up is advised |
| Dialani (2015)34 | 29 | Yes | 2/29 (6.9%) | 0 | 2† | EXC is warranted ONLY if the target lesion is not entirely removed on CNB |
| Calhoun (2015)35 | 94 | Yes | 5/94 (7%) | 2§ | 3 | EXC is not mandatory if target lesion entirely removed by CNB |
| McCroskey (2018)26 | 43 | Yes | 1/43 (2%) | 1§ | 0 | EXC is not mandatory |
| Ouldamer (2018)25 | 20 | Yes | 3/20 (15%) | 1 | 2 | EXC is warranted ONLY if target lesion is Ca2+ spanning >10 mm, with > 4 foci of FEA on CNB in patients > age 57 years |
| Hugar (2019)19 | 111* | Yes | 1/111 (1%) | 1§ | 0 | EXC is not mandatory; close imaging follow up is advised |
| Current study | 40‡ | Yes | 2/40 (5%) | 2§ | 0 | EXC is not mandatory if no personal history of breast carcinoma; close imaging follow up is advised |
| Totals | 543 | as above | 35/543 (6%) | 20/543 (3%) | 15/543 (3%) | as above |
†
Upgrades consisted of one ductal carcinoma in situ (DCIS) and one pleomorphic lobular carcinoma in situ (LCIS)
*
Excluding CNBs done for indications other than calcifications
‡
Excluding patients with prior and/or concurrent invasive carcinoma and/or DCIS
§
Invasive carcinoma deemed incidental finding
CNB – core needle biopsy, EXC – excision, NA – not available, Ca2+ - calcifications