ArticleDiagnostic and interventional radiology (Ankara, Turkey)2023
Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study.
Article in Diagnostic and interventional radiology (Ankara, Turkey), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- Vacuum-assisted breast biopsy vs core needle biopsy: a systematic review and meta-analysis.European radiology · 2026Pooled it
- Investigation of Factors Affecting Histopathological Upgrade in Breast Papillary Lesions: A Single-Center Study.Breast care (Basel, Switzerland) · 2026Article
- Predicting postoperative malignancy upgrading in B1-B3 breast lesions: combined utility of conventional ultrasound and contrast-enhanced ultrasound features.Quantitative imaging in medicine and surgery · 2026Article
- Tomosynthesis-Guided Vacuum-Assisted Excision of B3 Breast Lesions: Reducing Overtreatment Without Compromising Safety.European journal of breast health · 2026Article
- The role of the Kaiser score system in uncertain malignant potential (B3) breast lesions: a pilot study.Diagnostic and interventional radiology (Ankara, Turkey) · 2025Article
- Diagnostic accuracy of the breast MRI Kaiser score in suspected architectural distortions and its comparison with mammography.Scientific reports · 2024Article
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Authors and funding
46 authors at 20 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.
methodsThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson's chi-squared test, the Fisher-Freeman-Halton test, and Fisher's exact test were used for the statistical analyses.
resultsThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.
conclusionADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision.
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