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Follow-up of Breast Lesions Diagnosed as Benign with Stereotactic Core-Needle Biopsy: Frequency of Mammographic Change and False-Negative Rate¹

¹ From the Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06520. From the 1997 RSNA scientific assembly. Received August 11, 1998; revision requested September 25; revision received November 10; accepted January 11, 1999. Address reprint requests to C.H.L.

View larger version (179K): [in a new window]   Figure 1a. Increase in the number of calcifications. (a) Magnification craniocaudal view from a mammogram in a 47-year-old woman shows clustered pleomorphic microcalcifications (arrows). SCNB histologic analysis revealed fibrocystic change and ductal hyperplasia, with no evidence of malignancy. Microcalcifications were seen in nonproliferative lobules. (b) Magnification craniocaudal view from the same area on a mammogram obtained 36 months after the original SCNB shows an increase in the number of microcalcifications (arrows). Repeat SCNB yielded blunt ductal adenosis with microcalcifications.

View larger version (164K): [in a new window]   Figure 1b. Increase in the number of calcifications. (a) Magnification craniocaudal view from a mammogram in a 47-year-old woman shows clustered pleomorphic microcalcifications (arrows). SCNB histologic analysis revealed fibrocystic change and ductal hyperplasia, with no evidence of malignancy. Microcalcifications were seen in nonproliferative lobules. (b) Magnification craniocaudal view from the same area on a mammogram obtained 36 months after the original SCNB shows an increase in the number of microcalcifications (arrows). Repeat SCNB yielded blunt ductal adenosis with microcalcifications.

View larger version (154K): [in a new window]   Figure 2a. Increase in the size of a mass. (a) Left craniocaudal mammogram shows a lobulated, 2-cm mass (arrow) in a 36-year-old woman. The mass was not palpable and was diagnosed as a fibroadenoma with SCNB. (b) Left craniocaudal mammogram obtained at 18 months after the biopsy shows that the mass (arrow), which was clinically palpable, has increased to 3 cm. Excisional biopsy revealed a fibroadenoma with no evidence of malignancy.

View larger version (159K): [in a new window]   Figure 2b. Increase in the size of a mass. (a) Left craniocaudal mammogram shows a lobulated, 2-cm mass (arrow) in a 36-year-old woman. The mass was not palpable and was diagnosed as a fibroadenoma with SCNB. (b) Left craniocaudal mammogram obtained at 18 months after the biopsy shows that the mass (arrow), which was clinically palpable, has increased to 3 cm. Excisional biopsy revealed a fibroadenoma with no evidence of malignancy.

View larger version (145K): [in a new window]   Figure 3a. False-negative case. (a) Magnification craniocaudal mammogram in a 45-year-old woman shows calcifications (arrows) in the right breast, which had nonspecific benign SCNB histologic results. Retrieval of calcifications was documented with radiography of specimens, and calcifications were seen on the histologic slides. On the first follow-up mammogram in this patient, which was obtained 11 months after SCNB, the number of calcifications at the biopsy site was decreased. (b) Magnification craniocaudal mammogram obtained at the 24-month follow-up examination, however, shows that calcifications (arrows) at the site are increased in number. Excisional biopsy revealed ductal carcinoma in situ with microinvasion.

View larger version (145K): [in a new window]   Figure 3b. False-negative case. (a) Magnification craniocaudal mammogram in a 45-year-old woman shows calcifications (arrows) in the right breast, which had nonspecific benign SCNB histologic results. Retrieval of calcifications was documented with radiography of specimens, and calcifications were seen on the histologic slides. On the first follow-up mammogram in this patient, which was obtained 11 months after SCNB, the number of calcifications at the biopsy site was decreased. (b) Magnification craniocaudal mammogram obtained at the 24-month follow-up examination, however, shows that calcifications (arrows) at the site are increased in number. Excisional biopsy revealed ductal carcinoma in situ with microinvasion.