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Biomedical subjects

Georg Pfarl

Publications and source records attributed to Georg Pfarl.

5 recordsLinked to original sources
PubMed2005

Lesion miss rates and false-negative rates for 1115 consecutive cases of stereotactically guided needle-localized open breast biopsy with long-term follow-up.

PURPOSE: To retrospectively determine the lesion miss rate and false-negative rate of needle-localized open breast biopsy (NLOBB) with stereotactic guidance in a large study population. MATERIALS AND METHODS: The ethical review board approved the study; the need for informed consent was waived. A total of 1115 stereotactic NLOBBs performed in 1068 women aged 22-90 years (mean age, 54 years) were tracked to determine outcomes. In cases of malignancy, NLOBB was considered to be diagnostically successful. The mammographic outcomes in all patients with benign results at NLOBB were tracked for at least 2 years. Cases without such mammographic follow-up were cross-referenced with a tumor registry after at least 54 months. The lesion miss rate was based on all malignant lesions and all lesions with long-term mammographic follow-up. Results from all 1115 NLOBBs were used to report the false-negative rate. RESULTS: Of 1115 NLOBBs, 472 (42%) had malignant results. Mammographic follow-up data were available for 535 (83%) of 643 NLOBBs with benign results. Mammographic follow-up revealed 11 lesions that were missed with NLOBB, of which five were malignant and six benign. Thus, the lesion miss rate with NLOBB was 1.1% (11/[472 + 535]). Among the 643 cases, in 108 of them without mammographic follow-up (17%), cross-referencing with a tumor registry did not reveal missed cases of breast carcinoma. The false-negative rate was therefore 1.0% (5/[472 + 5]). CONCLUSION: On the basis of the results of long-term follow-up, the authors noted a lesion miss rate of 1.1% and a false-negative rate of 1.0%, which indicate that NLOBB with stereotactic guidance is an accurate method for diagnosing breast lesions.

Adult↗
PubMed2005

Potential of dose reduction after marker placement with full-field digital mammography.

OBJECTIVES: The purpose of our study was to assess the potential for radiation dose reduction in digital postinterventional digital mammograms after marker placement. MATERIALS AND METHODS: One hundred consecutive cases of marker placement (hook-wire localization or postbiopsy clip marker placement), with 200 full-field digital baseline mammograms (craniocaudal and mediolateral), were included in this prospective trial. For the postinterventional digital mammograms, the milliampere seconds were reduced either by 50% or by 75%. Dose-reduced images were evaluated for sufficient image quality to verify the position of the marker. RESULTS: In 193 of 200 cases (96.5%), image quality was sufficient to verify the correct position of the marker. One (1%) case with insufficient image quality occurred in the 50% dose-reduction group and 6 (6%) in the 75% dose-reduction group (P = 0.06). CONCLUSION: Our results indicate that under evaluation of each individual case, a dose reduction of 50% to 75% can be recommended in postinterventional digital mammograms.

Breast Neoplasms↗
PubMed2004

Stereotactic 11-gauge vacuum-assisted breast biopsy: influence of number of specimens on diagnostic accuracy.

PURPOSE: To determine whether number of specimens obtained at stereotactic 11-gauge vacuum-assisted breast biopsy with the patient prone influences diagnostic accuracy and to determine whether this number varies depending on mammographic appearance of lesions as masses or microcalcifications. MATERIALS AND METHODS: Biopsy was prospectively performed in 100 patients (median age, 55 years; range, 31-81 years) with 100 lesions that were mammographically evident as masses (n = 50) and microcalcifications (n = 50) with standardized protocol to acquire 20 specimens per lesion in three 360 degrees probe rotations at one skin entry site. Specimens were histologically evaluated sequentially, and findings were compared with results of surgical excision or of mammographic follow-up for at least 24 months. Differences in diagnostic yield after each probe rotation and differences in diagnostic yield between masses and microcalcifications were determined with chi(2) test. RESULTS: Up to 12 specimens harvested within two 360 degrees probe rotations were necessary to yield correct diagnosis in 96% of patients with masses and 92% of patients with microcalcifications. Diagnostic yield was not improved with more than 12 specimens for masses or microcalcifications. In two (4%) of 47 patients with lesions that were eventually diagnosed as cancer, results at stereotactic biopsy indicated they were benign. Underestimation of diagnosis of lesions as atypical ductal hyperplasia and ductal carcinoma in situ occurred in two (50%) of four and two (17%) of 12 lesions, respectively. With 20 specimens harvested during three probe rotations, there was no statistically significant difference in diagnostic yield between patients with masses and those with microcalcifications (P =.68). CONCLUSION: At 11-gauge vacuum-assisted biopsy, highest diagnostic yield was achieved with 12 specimens per lesion, independent of mammographic appearance of the lesion. Even with standardized retrieval of 20 specimens per lesion, underestimation of disease still occurs.

Adult↗
PubMed2002

Stereotactic 11-gauge vacuum-assisted breast biopsy: a validation study.

OBJECTIVE: The aim of our study was to determine the false-negative rate of stereotactic 11-gauge vacuum-assisted biopsy in a validation study of lesions that had subsequent surgical excision. MATERIALS AND METHODS: Retrospective review was performed of 318 lesions that underwent stereotactic 11-gauge vacuum-assisted biopsy and subsequent surgical excision. A false-negative case was defined as a pathologically proven cancer in which stereotactic biopsy yielded benign results without atypia. Medical records, imaging studies, and histologic findings were reviewed. RESULTS: False-negative findings were encountered at stereotactic 11-gauge vacuum-assisted biopsy in 3.3% (7/214) of pathologically proven cancers. False-negative findings occurred in 3.5% (4/115) of malignant calcification lesions versus 3.0% (3/99) of malignant masses (p = 1.0). The seven false-negative findings included five Breast Imaging Reporting and Data System (BI-RADS) category 5 lesions that yielded benign results at biopsy, one BI-RADS category 4 mass that benign breast tissue, and one BI-RADS category 4 cluster of calcifications in which no calcifications were retrieved. The false-negative rate was 10.0% (6/60) for radiologists who performed 15 or fewer previous stereotactic vacuum-assisted biopsy procedures versus 0.6% (1/154) for radiologists who performed more than 15 previous stereotactic vacuum-assisted biopsy procedures (p = 0.002). CONCLUSION: Stereotactic 11-gauge vacuum-assisted biopsy had a false-negative rate of 3.3% that diminished to 0.6% with experience. All false-negative findings could be prospectively identified because of failure to sample calcifications or imaging-histologic discordance.

Adult↗