Recommendations for excision following core needle biopsy of the breast: a contemporary evaluation of the literature

Histopathology
Benjamin C Calhoun, Laura C Collins

Abstract

Pathologists frequently encounter non-malignant histological findings in percutaneous core needle biopsies (CNBs). Standards for the management of patients with lesions such as atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ, as well as other benign lesions, are not well defined, and recommendations for surgical biopsy or continued clinical and radiological follow-up are inconsistent. The frequency with which these lesions are 'upgraded' to carcinoma in excision specimens is widely variable in the literature. Many CNB studies lack careful radiological-pathological correlation, clear criteria for excision, and clinical follow-up for patients on whom excision was not performed. This review of the recent literature emphasizes studies with radiological-pathological correlation, with the goal of developing a contemporary, evidence-based approach to the management of non-malignant lesions of the breast diagnosed on CNB. The data supporting an emerging consensus on which lesions may not require excision are highlighted. The management of non-malignant lesions diagnosed on magnetic resonance imaging-guided CNB is also discussed.

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Citations

Aug 20, 2016·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Kelly L MooneySophia K Apple
Nov 4, 2016·Annals of Diagnostic Pathology·Benjamin C CalhounErinn Downs-Kelly
Nov 30, 2019·Virchows Archiv : an International Journal of Pathology·Iskender Sinan GencoSabina Hajiyeva
Nov 22, 2017·Archives of Pathology & Laboratory Medicine·Kristen E MullerJulie M Jorns
May 4, 2018·Breast Cancer Research : BCR·Tanjina KaderKylie L Gorringe
Aug 18, 2018·BMC Cancer·Christiane Richter-EhrensteinTilman Ehrenstein
May 22, 2018·The Breast Journal·Sarah P RooneyJulie M Jorns
Sep 27, 2019·Deutsches Ärzteblatt International·Angrit StachsSteffi Hartmann
Nov 5, 2021·Virchows Archiv : an International Journal of Pathology·Janina KulkaSigurd F Lax

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