Jacky Luiten

Utility of diagnostic breast excision biopsies during two decades of screening mammography | 39 3 Table 3.1 Screening year 97/98 99/00 01/02 03/04 05/06 07/08 09/10 11/12 13/14 15/16 Total Screens 48,721 53,718 53,489 61,251 66,300 67,530 90,128 113,335 131,427 131,757 817,656 Excisional biopsy Benign (%) (pre) Malignant (%) 214 69 (32.2) 145 (67.8) 175 47 (26.9) 128 (73.1) 103 41 (39.8) 62 (60.2) 87 53 (60.9) 34 (39.1) 27 17 (63.0) 10 (37.0) 37 22 (59.5) 15 (40.5) 39 29 (74.4) 10 (25.6) 61 44 (72.1) 17 (27.9) 81 61 (75.3) 20 (24.7) 84 59 (70.2) 25 (29.8) 908 442 (48.7) 466 (51.3) per 1,000 screens Benign (pre) Malignant 4.4 1.4 3.0 3.3 0.9 2.4 1.9 0.8 1.2 1.4 0.9 0.5 0.4 0.3 0.2 0.5 0.3 0.2 0.4 0.3 0.1 0.5 0.4 0.1 0.6 0.5 0.2 0.6 0.4 0.2 1.1 0.5 0.6 Benign/(pre)malignant ratio 0.48 0.37 0.66 1.6 1.7 1.5 2.9 2.6 3.1 2.4 0.95 Excisional biopsy and outcome Primary excisional biopsy (%^) Benign (%) (pre) Malignant (%) 167 (78.0) 52 (31.1) 115 (68.9) 132 (75.4) 32 (24.2) 100 (75.8) 59 (57.3) 25 (42.4) 34 (57.6) 25 (28.7) 14 (56.0) 11 (44.0) 6 (22.2) 1 (16.7) 5 (83.3) 6 (16.2) 4 (66.7) 2 (33.3) 3 (7.7) 1 (33.3) 2 (66.7) 6 (9.8) 3 (50.0) 3 (50.0) 9 (11.1) 2 (22.2) 7 (77.8) ‐ ‐ ‐ 413 (45.5) 134 (32.4) 279 (67.6) Secondary excisional biopsy (%^) Benign (%) (pre) Malignant (%) 47 (22.0) 19 (40.4) 28 (59.6) 43 (24.6) 15 (34.9) 28 (65.1) 44 (42.7) 16 (36.4) 28 (63.6) 62 (71.3) 39 (62.9) 23 (37.1) 21 (77.8) 13 (61.9) 8 (38.1) 31 (83.8) 18 (58.1) 13 (41.9) 36 (92.3) 28 (77.8) 8 (22.2) 55 (90.2) 41 (74.5) 14 (25.5) 72 (88.9) 55 (76.4) 17 (23.6) 84 (100) 59 (70.2) 25 (29.8) 495 (54.5) 303 (61.2) 192 (38.8) Indication for secondary excisional biopsy Suspicious findings at percutaneous biopsy A Benign (%  ) (pre) Malignant (%  ) 5 (10.6) 6 (12.8) 5 (11.6) 7 (16.3) 4 (9.1) 11 (25.0) 16 (25.8) 9 (14.5) 5 (23.8) 4 (19.0) 6 (19.4) 7 (22.6) 24 (66.7) 3 (8.3) 33 (60.0) 11 (20.0) 51 (70.8) 13 (18.1) 44 (65.8) 22 (23.7) 193 (39.0) 93 (18.2) Discordance B Benign (%  ) (pre) Malignant (%  ) 7 (14.9) 8 (17.0) 8 (18.6) 11 (25.6) 12 (19.4) 8 (12.9) 12 (19.4) 8 (12.9) 4 (19.0) 1 (4.8) 11 (35.5) 1 (3.2) 1 (2.8) 2 (5.6) 2 (3.6) 2 (3.6) 2 (2.8) 2 (2.8) 9 (10.7) 1 (1.2) 61 (12.3) 48 (9.7) Inadequate percutaneous biopsy C Benign (%  ) (pre) Malignant (%  ) 3 (6.4) 14 (29.8) 2 (4.7) 10 (23.3) 8 (12.9) 6 (9.7) 8 (12.9) 6 (9.7) 2 (9.5) 2 (9.5) 1 (3.2) 5 (16.1) 3 (8.3) 1 (2.8) 3 (5.5) 1 (1.8) ‐ 2 (2.8) 5 (6.0) 2 (2.4) 28 (5.7) 48 (9.7) Patient related D Benign (%  ) (pre) Malignant (%  ) 2 (4.3) ‐ ‐ ‐ 3 (6.8) 2 (3.2) 1 (4.8) 1 (4.8) ‐ ‐ ‐ 2 (5.6) 2 (3.6) ‐ 2 (2.8) ‐ 1 (1.2) ‐ 13 (2.6) 3 (0.6) Other E Benign (%  ) 2 (4.3) ‐ 3 (6.8) 1 (6.1) 1 (4.8) ‐ ‐ 1 (1.8) ‐ ‐ 8 (1.6) ^ percentage out of all excision biopsies;  percentage of secondary excision biopsies; A borderline lesion for which the pathologist is unable to guarantee benign disorder; B Benign percutaneous biopsy but suspicious radiological findings; C inadequate tissue sample and or uncertainty of representativeness; D patient anxiety or other patient related factors for which excision was decided upon ; E persistent uncertainty despite adequate tissue sample.