Abstract
This audit was performed in order to clarify any relationship between an increase in benign biopsies and use of the B3 core biopsy category. Women who had been screened between 1 April 1999 and 31 March 2000 by Leeds/Wakefield Breast Screening Service and who had undergone a surgical biopsy for a lesion subsequently proving benign were identified and all pre-operative investigations reviewed. Thirty-six women had undergone a surgical excision biopsy for a benign lesion and 22 of these (61%) had had a B3 biopsy categorisation. Twelve of these reflected a pathological suggestion of radial scar but there were 10 others and a wide variety of lesions were represented. Two papillary lesions, two fibro-epithelial lesions, two difficult intraductal epithelial proliferations and two biopsies containing pools of stromal mucin were found, as was one case of atypical lobular hyperplasia and one unusual vascular lesion. We suggest there may be a relationship between the histological uncertainty, which may arise as a consequence of the limited sampling of core biopsy and a rise in the number of benign biopsies performed. It is possible that newer vacuum assisted techniques such as the mammotome may prove helpful in avoiding the need for open biopsy in some of these patients.
Highlights
Histological analysis of core biopsy of breast lesions takes a minimum of 24 h, but imprint cytology of a core biopsy can be reported within an hour
A total of 450,425 women were screened by BreastScreen Western Australia (BSWA) from January 1990 to December 2000. 2,314 cancers were detected with a total cancer detection rate of 5.1 cancers per 1,000 women screened. 4,916 women of ATSI origin were screened during this interval. 31 breast cancers were diagnosed, with a total cancer detection rate of 6.3 cancers per 1,000 women screened
These lesions may mimic the microcalcifications of ductal carcinoma in situ at screening mammography
Summary
Histological analysis of core biopsy of breast lesions takes a minimum of 24 h, but imprint cytology of a core biopsy can be reported within an hour. This study validates the accuracy of imprint cytology from core biopsy of breast lesions obtained under ultrasound control. Full field digital mammography (FFDM) seems set to replace conventional film-screen technique. Concern has been raised over FFDM diminished spatial resolution (5–6 Ip/mm). If valid, this could compromise detection of calcification and diagnosis of ductal carcinoma in situ (DCIS). In our centre we were not able to perceive any difference between microfocus magnification and on-screen magnification when assessing microcalcification. We subsequently compared these results with average scores for over 90 film-screen mammography systems
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