title: Borderline breast lesions: comparison of malignancy underestimation rates with 14-gauge core needle biopsy versus 11-gauge vacuum-assisted device.
abstract: OBJECTIVE
  To compare malignancy underestimation rates in the case of percutaneous diagnosis of borderline breast lesions(B3) at 14-g core-needle-biopsy (CNB) and at 11-g vacuum-assisted-biopsy (VAB).
  
  
  METHODS
  The histological results of 4764 image-guided breast biopsies were retrospectively reviewed. 300 B3, 151 benign papillomas, 88 radial sclerosing lesions, 46 lobular neoplasia, 15 atypical ductal hyperplasia diagnosed at ultrasound-guided 14-g CNB (76%) or stereotactically-guided 11-g VAB (24%) were identified. On average, 5 cores were obtained with CNB and 12 with VAB. Biopsy variables were reviewed and correlated with surgical excision or follow-up (>24 months). Lesion- and device-specific underestimation rates of malignancy were calculated.
  
  
  RESULTS
  Surgical excision was performed on 237 lesions: 178 were benign, 21 atypical, 38 cancers. The remaining 63 lesions were unchanged at follow-up. Overall malignancy underestimation rate was 12.7% at 14-g CNB and 12.5% at 11-g VAB. Based on excision histology or follow-up, lesion-specific underestimation rates were: benign papillomas: 14-g CNB 11%, 11-g VAB 0%; RSL: 14-g CNB 6%, 11-g VAB 4%; LN: 14-g CNB 40%, 11-g VAB 23%; ADH: 14-g CNB 33%; 11-g VAB 22%.
  
  
  CONCLUSIONS
  In the case of percutaneous diagnosis of B3 lesions, underestimation of malignancy occurs regardless of the biopsy method.
authors.affiliation: Institute of Radiology, University of Udine, Azienda Ospedaliero Universitaria di Udine, P.le S.Maria della Misericordia, 33100, Udine, Italy. londero.viviana@aoud.sanita.fvg.it
authors.forename: Viviana
authors.initials: V
authors.lastname: Londero
authors.forename: Chiara
authors.initials: C
authors.lastname: Zuiani
authors.forename: Anna
authors.initials: A
authors.lastname: Linda
authors.forename: Luisa
authors.initials: L
authors.lastname: Battigelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Brondani
authors.forename: Massimo
authors.initials: M
authors.lastname: Bazzocchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001707:Biopsy, Needle / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D019544:Equipment Failure Analysis; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D009339:Needles; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods*; D016217:Ultrasonography, Mammary / Q000379:methods