title: Radial scar without associated atypical epithelial proliferation on image-guided 14-gauge needle core biopsy: analysis of 49 cases from a single-centre and review of the literature.
abstract: The purpose of this study was to evaluate the reliability of image-guided 14-gauge needle core biopsy in the diagnosis of radial scar without associated atypical epithelial proliferation, by comparison with definitive histological diagnosis on surgical excision. The records of 8792 consecutive image-guided 14-gauge needle core biopsy of the breast performed from January 1996 to December 2009 were reviewed. Forty-nine cases of radial scar without associated atypical epithelial proliferation were identified and compared with definitive histological diagnosis on surgical excision. The definitive histological diagnosis on surgical excision confirmed the results of image-guided 14-gauge needle core biopsy in 36 of 49 cases (73.5%), in 9 cases (18.3%) radial scar was associated with atypical epithelial proliferation, while 4 cases out of 49 cases were upgraded to carcinoma (3 cases of ductal carcinoma in situ and one case of invasive lobular carcinoma), with an underestimation rate of 8.2%. A diagnosis of radial scar without associated atypical epithelial proliferation on image-guided 14-gauge needle core biopsy does not exclude a malignancy on surgical excision; consequently during the multidisciplinary discussion further assessment by surgical excision or vacuum-assisted excision, as recently reported, needs to be considered to obtain a definitive histological diagnosis.
authors.affiliation: Pathological Anatomy Unit, Department of Critical Care Medicine and Surgery, AOU Careggi, Largo G.A. Brambilla 3, 50134 Florence, Italy. simonetta.bianchi@unifi.it
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: E
authors.initials: E
authors.lastname: Giannotti
authors.forename: E
authors.initials: E
authors.lastname: Vanzi
authors.forename: M
authors.initials: M
authors.lastname: Marziali
authors.forename: D
authors.initials: D
authors.lastname: Abdulcadir
authors.forename: C
authors.initials: C
authors.lastname: Boeri
authors.forename: L
authors.initials: L
authors.lastname: Livi
authors.forename: L
authors.initials: L
authors.lastname: Orzalesi
authors.forename: L J
authors.initials: LJ
authors.lastname: Sanchez
authors.forename: T
authors.initials: T
authors.lastname: Susini
authors.forename: V
authors.initials: V
authors.lastname: Vezzosi
authors.forename: J
authors.initials: J
authors.lastname: Nori
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000175:diagnosis* / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology*; D049109:Cell Proliferation; D002921:Cicatrix / Q000175:diagnosis* / Q000473:pathology; D004847:Epithelial Cells; D005260:Female; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies