The rate of imaging-histologic discordance of benign breast disease: a multidisciplinary approach to the management of discordance at a large university-based hospital.
BACKGROUND
Suspicious abnormalities seen on screening mammography require further imaging and histologic analysis. Any imaging-histologic discordance necessitates further imaging or surgical excision.


METHODS
A retrospective review of all patients with evidence of benign breast lesions having imaging-histologic discordance from January 2005 to December 2007 was compared with the results of a previous study from January 2002 to September 2004.


RESULTS
Of 1,264 benign cases, 25 patients had discordance (2%). Surgical intervention was required in 14 of 25 of all discordant cases (56%). One discordant case was found to be malignant after open excision, giving a false-negative rate of 4%. Previous data reported an 8.8% discordance rate, with 65.2% requiring surgical intervention and a false-negative rate of 29.3%. On comparison, the rate of discordance and false-negative image-directed core biopsies were decreased (P<.05).


CONCLUSIONS
An organized multidisciplinary approach to imaging-histologic discordance in benign breast disease decreases the rate of discordance and unnecessary surgical interventions.
Virginia Tech, Carilion School of Medicine, 1906 Bellview Avenue, Roanoke, VA 24018, USA. jmihalik@carilion.com
Jennifer E
JE
Mihalik
Lisa
L
Krupka
Roxanne
R
Davenport
Lee
L
Tucker
Christine
C
Toevs
R Stephen
RS
Smith
D001706:Biopsy; D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008327:Mammography; D010348:Patient Care Team; D012189:Retrospective Studies