Criteria for Excision of Suspicious Calcifications Using the Breast Lesion Excision System (BLES)

Background: The aim of the study was to retrospectively evaluate possibleimaging and histopathology criteria that can be used in a clinical basis to assess thesuccess of excision of suspicious calcifications using the breast lesion excisionsystem (BLES).Methods: We investigated ۴۰۰ BLES stereotactic biopsies of suspiciouscalcifications with the mean size of ۱۵.۳۸ mm (st. dev.= ۱۳.۵۷۹ mm, range ۳-۷۸ mm)using a ۲۰ mm probe performed in our department between January ۲۰۱۴ and ۲۰۱۶.The mean age of our population was ۵۸.۵ years old (range ۳۹-۷۸ years). Thepathology results of BLES specimens were compared with the final surgical resultsto assess excision success rates. Possible imaging and histopathology criteria forremoval were statistically analyzed (mammographic size, disease free margins,grade, comedo phenotype, molecular type).Results: The results showed that ۹۰/۴۰۰ (۲۲.۵%) biopsies were cancers (۸۰%DCIS) and ۳۸/۴۰۰ were lesions with cell atypia (۹.۵%) of which ۲۹/۳۸ hadsubsequent surgery and were included in the study. Excision was achieved in ۳۱/۹۰cancers (۳۴.۴%) and in ۲۳/۲۹ lesions with cell atypia (۷۶.۳%). The imaging andhistopathology criteria for BLES excision that could be potentially clinicallyassessed were the initial mammographic size (p<۰.۰۰۱), the distance of the lesionfrom the specimen margins (p<۰.۰۰۱), the presence of comedo necrosis (p=۰.۰۱۴)and the grade of the cancers (p=۰.۰۲۱). The underestimation rate was ۱۵.۵%.Conclusion: the mammographic size, grade, comedo presence and disease-freemargins, were the main criteria for BLES success rate of excision of suspiciouscalcifications.

Keywords:

Breast lesion excision system (BLES) , breast cancer , calcifications , biopsy