title: Does Initial Imaging Modality Affect Breast Biopsy Upgrade Rates? A Single Institution Review.
abstract: BACKGROUND
  Image-guided core needle biopsy (CNB) is the standard for diagnostic breast biopsy. However, the upgrade rate to a higher order lesion defined as identification of malignancy on final pathology from surgical excision remains problematic.
  
  
  METHODS
  A retrospective chart review of all core needle biopsies from 2008 to 2012 was performed. We identified lesions demonstrating atypia without associated malignancy on core needle biopsy and recorded multiple factors to evaluate predictors of upgrade.
  
  
  RESULTS
  Of 151 independent core needle biopsies recorded, 26.5% were upgraded to a higher order lesion. Concurrent mammogram and ultrasound (US) were associated with higher sampling error than any individual imaging modality (P = .021). MRI had a trend toward lower rate of upgrade rate but did not reach statistical significance.
  
  
  CONCLUSIONS
  Although MRI had a lower rate of upgrade rate due to sampling error, this did not reach significance possibly because of our small sample size.
authors: Rachel B
authors: RB
authors: Scott
authors: Tsetan
authors: T
authors: Dolkar
authors: Ramapriya
authors: R
authors: Vidhun
authors: Turner
authors: T
authors: Osler
authors: Valerie L
authors: VL
authors: Staradub
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062005:Biopsy, Large-Core Needle; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary / Q000706:statistics & numerical data