Table 3 Core needle biopsies with benign findings.

From: Breast lesions associated with mammographic architectural distortion: a study of 588 core needle biopsies

Histologic category

Number

Number excised (%)

No. with correlating benign lesion on excision (%)

No. with malignancy on excision (%)

Lesions very likely to correlate with architectural distortion

Sclerosing lesionsa

186

   

    Complex sclerosing lesion

84

59 (70%)

57 (97%)

1 (2%)

1 DCIS

    Radial sclerosing lesion

20

14 (70%)

12 (86%)

0

    Sclerosing adenosis

36

14 (39%)

14 (100%)

0

    With Atypiab

27

25 (93%)

21 (84%)

7 (33%)

5 DCIS/2 invasive

    With ALH/LCIS (classic)c

19

10 (53%)

7 (70%)

2 (20%)

1 DCIS/1 invasive

Other benign findings

32

   

 Scarring due to biopsy or traumad

16

5 (31%)

5 (100%)

0

 Cysts with rupturee

14

1 (7%)

1 (100%)

0

 Fat necrosis

2

1 (50%)

1 (100%)

0

Total (excluding atypia and ALH/LCIS)

172

94 (55%)

90 (96%)

1 (1%)

Lesions that may or may not correlate with architectural distortion

Nonspecific benign changesf

81

34 (42%)

13 (38%)

4 (12%)

4 invasive

Dense stromag

68

29 (43%)

15 (52%)

1 (3%)

1 invasive

Fibroadenoma/fibroadenomatoid change

10

4 (40%)

3 (75%)

1 (25%)

1 invasive

Papilloma

1

1

1 (100%–1.3 cm papilloma)

0

With Atypiah

12

10 (83%)

2 (17%)

4 (33%)

2 DCIS/2 invasive

With ALH/LCIS (classic)i

14

9 (69%)

4 (44%)

4 (44%)

2 DCIS/2 invasive

Total (excluding atypia and LCIS/ALH)

160

68 (43%)

32 (47%)

6 (9%)

  1. aSclerosing lesions included those that were classified as complex sclerosing lesions, radial sclerosing lesions (radial scars), and sclerosing adenosis on core needle biopsy.
  2. bAtypia included 16 cases of ADH (2 with invasive carcinoma and 3 with DCIS involving complex sclerosing adenosis (CSL) on excision), 3 cases of atypical apocrine adenosis (1 with DCIS in a CSL on excision), 3 nonclassic lobular lesions (1 with DCIS on excision), 3 cases of architectural atypia, and 2 cases of flat epithelial atypia.
  3. cLobular lesions included 14 cases of ALH (1 with DCIS on excision) and 5 cases of LCIS (1 with invasive carcinoma on excision).
  4. dScarring due to biopsy or trauma was identified as reactive, typically dense, stroma with chronic inflammation, giant cell reaction, and with or without fat necrosis.
  5. eCysts with rupture showed areas of reactive stroma with chronic inflammation reacting to cyst contents.
  6. fNonspecific benign changes included findings that do not have a definite correlation with architectural distortion including UDH, CCC, micro-cysts (without rupture), micro-papillomas, and pseudoangiomatous stromal change.
  7. gDense stroma included cases in which dense or fibrotic stroma was noted but with insufficient features to suggest a sclerosing lesion or a scar.
  8. h“Atypia” consisted of 9 cases of ADH (associated with 1 case of DCIS and 2 cases of invasive carcinoma on excision), 1 case with an epithelial proliferation with architectural atypia (associated with DCIS on excision), 1 case of FEA, and 1 case of atypical apocrine adenosis.
  9. iCases of lobular neoplasia consisted of 13 cases of ALH (associated with 2 cases of invasive carcinoma and 2 cases of DCIS on excision) and 1 case of LCIS.
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