Table 1.
Univariable logistic regression: clinical and pathologic variables associated with a false-negative vacuum-assisted biopsy after neoadjuvant systemic treatment
| Variables | OR | p Value | FNR (95% CI) |
|---|---|---|---|
| Age | 1.03 | 0.04a | |
| Tumor biology | |||
| HER2+ | 1.65 | 0.24 | 25.0 (14.7–37.9) |
| HR+/HER2– | 1.49 | 0.36 | 14.1 (7.7–23.0) |
| TNBC | Reference | – | 17.0 (8.1–29.8) |
| cT stage before NST | |||
| cT1 | Reference | – | 13.7 (7.7–22.0) |
| cT2 | 1.37 | 0.39 | 20.9 (13.1–30.7) |
| cT3 | 2.43 | 0.15 | 28.6 (8.4–58.1) |
| cT stage after NST | |||
| ycT0 | Reference | 22.0 (12.3–34.7) | |
| ycT1 | 1.13 | 0.75 | 13.1 (7.7–20.4) |
| ycT2 | 3.72 | 0.017 | 27.3 (10.7–50.2) |
| ycT3 | 6.19 | 0.15 | 50.0 (1.3–98.7) |
| No. of biopsies | |||
| < 6 | Reference | – | |
| ≥ 6 | 1.99 | 0.16 | 19.8 (13.9–26.7) |
| Categorized as representative by the biopsying physician | |||
| Yes | 2.1 | 0.13 | 16.7 (11.6–22.8) |
| No | Reference | – | 30.0 (11.9–54.3) |
| Needle size (G) | |||
| 10 | Reference | – | 14.7 (7.3–25.4) |
| 9 | 2.56 | 0.15 | 30.8 (9.1–61.4) |
| 8 | 1.45 | 0.36 | 21.2 (13.8–30.3) |
| 7 | 0 | 0.99 | 0.0 (0.0–18.5) |
| Multicentricity before NST | |||
| Yes | 2.4 | 0.09a | 38.5 (15.7–66.0) |
| No | Reference | – | 16.5 (11.8–22.2) |
| Multicentricity after NST | |||
| Yes | 3.34 | 0.05a | 36.4 (12.8–66.4) |
| No | Reference | – | 16.4 (11.7–22.1) |
| Multifocality before NST | |||
| Yes | 0.89 | 0.84 | 14.8 (4.8–32.0) |
| No | Reference | – | 18.3 (13.2–24.5) |
| Multifocality after NST | |||
| Yes | 1.22 | 0.76 | 16.0 (4.4–39.0) |
| No | Reference | – | 17.6 (12.6–23.5) |
| Accompanying DCIS in initial diagnostic biopsy | |||
| Yes | 3.65 | <0.001a | 19.5 (12.4–28.6) |
| No | Reference | – | 16.5 (10.6–24.2) |
| Radiography: clip marker visible in biopsy specimen | |||
| Yes | Reference | – | 14.0 (6.3–25.7) |
| No | 1.74 | 0.23 | 19.6 (12.8–28.2) |
| Radiography: lesion of diagnostic biopsy visible in VAB specimen | |||
| Yes | Reference | – | 13.4 (7.3–22.1) |
| No | 1.14 | 0.75 | 23.9 (14.8–35.1) |
| Microcalcifications before NST | |||
| Yes | 0.88 | 0.78 | 12.8 (5.3–24.7) |
| No | Reference | – | 21.2 (15.1–30.2) |
| Microcalcifications after NST | |||
| Yes | 0.59 | 0.41 | 9.1 (2.4–22.8) |
| No | Reference | – | 21.2 (14.1–30.0) |
| Grading | |||
| G1/G2/Gx | 1.51 | 0.24 | 17.0 (10.7–25.6) |
| G3 | Reference | – | 18.9 (12.3–27.2) |
| Tumor subtype | |||
| No special type | Reference | – | 18.5 (13.5–24.5) |
| ILC | 1.06 | 0.95 | 10.0 (0.5–40.3) |
| Other | 0.64 | 0.67 | 12.5 (0.6–48.0) |
| Time requirement for VAB | 1.01 | 0.31 | |
| Clip marker present and within the former lesion | |||
| Yes | Reference | – | 17.2 (12.0–23.4) |
| No | 1.57 | 0.32 | 21.9 (10.1–38.5) |
| Organizational setting for VAB | |||
| Ambulant | Reference | – | 20.6 (13.4–29.5) |
| Day of the surgery | 2.21 | 0.79 | |
| In operating room | 1.4 | 0.34 | 15.5 (8.5–25.0) |
| Other | 1.13 | 0.13 | |
| Biopsy guidance procedure | |||
| US-guided | Reference | – | 8.6 (5.7–12.3) |
| Stereotactic-guided | 1.48 | 0.32 | 12.2 (6.0–21.3) |
OR odds ratio, FNR false-negative rate, CI, confidence interval, HER2 human epidermal growth factor 2, HR hormone receptor; TNBC triple negative breast cancer, NST neoadjuvant systemic therapy, DCIS ductal carcinoma in situ; ILC invasive lobular carcinoma, VAB vacuum-assisted biopsy, US ultrasound
aThese variables were included in the multivariate logistical regression