Percutaneous Biopsies: Histopathological Aspects

  • Fernando Nalesso Aguiar
  • Filomena Marino de Carvalho


Percutaneous biopsies with histological sampling enabled the reduction of unnecessary surgeries in benign lesions and enhanced therapeutic planning in cases of malignant neoplasia. However, they require proper interpretation from the clinic, radiologic, and histologic context to minimize false-negative results. Therefore, the following are mandatory:

Recommended Bibliography

  1. 1.
    Marcil G, Wong S, Trabulsi N, Allard-Coutu A, Parsyan A, Omeroglu A, et al. Fibroepithelial breast lesions diagnosed by core needle biopsy demonstrate a moderate rate of upstaging to phyllodes tumors. Am J Surg. 2016. Retrospective study with 74 percutaneous biopsies diagnosed as nodular fibroepithelial lesion. The surgical excision was performed in 48 (64.9%) and the final diagnoses were fibroadenoma (62.5%), benign Pphyllodes tumor (29.2%) and borderline Pphyllodes tumor (8.3%). The Findings predictive diagnosis of Phyllodes were was stablished by: BIRADS score ≥ 4b, heterogeneous texture and lack of central vascularity by to the ultrasoundGoogle Scholar
  2. 2.
    Mayer S, Kayser G, Rucker G, Bögner D, Hirschfeld M, Hug C, et al. Absence of epithelial atypia in B3-lesions of the breast is associated with decreased risk for malignancy. Breast. 2017;31:144–9. Retrospective study with 219 patients subjected to surgical excisional biopsy after diagnosis of histological lesion B3 by percutaneous biopsy. The general underestimation rate was 10%. Atypical lesions had higher rates (24% vs. 4.8%), as well as in the subgroup of Papillaryuliferous lesions (28.6% vs. 4.7%).CrossRefGoogle Scholar
  3. 3.
    Mooney KL, Bassett LW, Apple SK. Upgrade rates of high-risk breast lesions diagnosed on core needle biopsy: a single institution experience and literature review. Mod Pathol. 2016;29:1471–84. Retrospective revisional study of 5750 revised percutaneous biopsies and further analysis of 462 high-risk lesions (epithelial atypia and radial scars). The underestimation rates were 18% for atypical ductal hyperplasia, 11% for flat epithelial atypia, 9% for atypical lobular hyperplasia, 28% for CLIS, and 16% for radialted scarring. Benign nature was indicated by the total excision of microcalcifications, the size < 1 cm and for the CLIS, the as an incidental finding.CrossRefGoogle Scholar
  4. 4.
    Saladin C, Haueisen H, Kampmann G, Oehlschlegel C, Seifert B, Rageth L, et al. Lesions with unclear malignant potential (B3) after minimally invasive breast biopsy: evaluation of vacuum biopsies performed in Switzerland and recommended further management. Acta Radiol. 2016;57:815–21. Population study including all Mammotomies registered in the Swiss database in the period from 2009 to 2011 (9153 biopsies). The B3 rate was 17.0% and there was 21.5% underestimation (DCIS or invasive), thus distributed: atypical ductal hyperplasia – 25.9%; Flat epithelial atypia – 18.3%; Lobular neoplasiam – 26.4%, radial scarring – 11.1%, and papillary lesions – 3.1%.CrossRefGoogle Scholar
  5. 5.
    Seely JM, Verma R, Kielar A, Smyth KR, Hack K, Taljaard M, et al. Benign papillomas of the breast diagnosed on large – gauge vacuum biopsy compared with 14 gauge core needle biopsy – do they require surgical excision? Breast J. 2017;23:146–53. Retrospective study including the diagnosis of intraductal benign papilloma, 47 of them diagnosed by core biopsy (14 g) and 60 by Mammotomy (10/12 g). Total underestimation rRates (atypia, DCIS and invasive carcinoma) were 19.1% in the core group and 5% in the Mammotomy group, however the difference was not statistically significant.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Fernando Nalesso Aguiar
    • 1
  • Filomena Marino de Carvalho
    • 2
  1. 1.PathologyCancer Institute of São PauloSão PauloBrazil
  2. 2.PathologySão Paulo UniversitySão PauloBrazil

Personalised recommendations