Publications

Abstract

  • Pancholy B, Kazanjian K, Bae W, & Lum S. (2011). Factors Associated With Malignancy on Ultrasound-Guided Axillary Core Needle Biopsy. Annals of Surgical Oncology, 18, S177-S177. (04/2011)
  • Wong J, Olaya W, Bae W, Roy-Chowdhury S, Kazanjian K, & Lum S. (2010). The Impact of Needle Core Size and Number on Upgrade Rates of DCIS Diagnosed by Core Biopsy. Annals of Surgical Oncology, 17(2), S193-S193. (04/2010)
  • Olaya W, Wong J, Bae W, Roy-Chowdhury S, Kazanjian K, & Lum S. (2010). Are Percutaneous Biopsy Rates a Reasonable Quality Measure in Breast Cancer Management?. Annals of Surgical Oncology, 17(2), S184-S184. (04/2010)

Scholarly Journals--Published

  • Olaya W, Bae W, Wong J, Roy-Chowdhury S, Kazanjian K, & Lum S. (2010). Are percutaneous biopsy rates a reasonable quality measure in breast cancer management?. , 17 Suppl 3, 268-72. BACKGROUND: Utilization of percutaneous needle biopsy (PNB) has been proposed as a quality measure of breast cancer care. We evaluated rates and reasons for failure of patients undergoing PNB as the initial diagnostic procedure for evaluation of breast pathology. METHODS: We performed a retrospective review of sequential patients undergoing image-guided PNB and open surgical excisional breast biopsies from January 2006 to July 2009 at our institution. Factors associated with failure to undergo a percutaneous approach were analyzed. RESULTS: During the study period, 1196 breast biopsies were performed; 87 (7.3%) were open surgical biopsies, and 1109 (92.7%) were PNB. Imaging used for percutaneous guidance or needle localization was ultrasound in 58.9%, mammogram in 40.0%, and magnetic resonance imaging (MRI) in 0.9%. Open surgical excisional biopsy was associated with mammographic guidance (P < .001), location in the central or lower inner quadrant of the breast (P = .002), BIRADS score of 1 or 6 (P < .001), or calcifications as target (P < .001). There were no differences in rates of PNB by age, size of lesion, or breast density. Reasons for failure of PNB were technical (calcifications not visualized, proximity to implant, etc.) in 86.2% of cases. No reason was documented in 10.3%, and 3.4% of patients refused a percutaneous approach. CONCLUSIONS: The majority of patients in this series underwent PNB as an initial diagnostic approach. Most percutaneous failures are due to technical reasons. PNB rates are a reasonable quality measure in breast cancer care. Documentation of failure to meet this benchmark should be stringently monitored. (10/2010) (link)
  • Olaya W, Bae W, Wong J, Roy-Chowdhury S, Kazanjian K, & Lum S. (2010). Accuracy and upgrade rates of percutaneous breast biopsy: the surgeon's role. Am Surg, 76(10), 1084-7. We sought to evaluate the impact of needle core size and number of core samples on diagnostic accuracy and upgrade rates for image-guided core needle biopsies of the breast. A total of 234 patients underwent image-guided percutaneous needle biopsies and subsequent surgical excision. Large-core needles (9 gauge or less) were used in 14.5 per cent of cases and the remainder were performed with smaller core needles. More than four core samples were taken in 78.9 per cent of patients. In 71.8 per cent of cases, needle biopsy pathology matched surgical excision pathology. After surgical excision, upgraded pathology was revealed in 10.7 per cent of cases. Of 11 patients (52.4%) with benign needle core pathology who had upgraded final pathology on surgical excision, 10 had a Breast Imaging Recording and Data System score 4 or 5 imaging study. Lesions smaller than 10 mm were more likely to be misdiagnosed (P = 0.01) or have upgraded pathology (P = 0.009). Other predictors of upgraded pathology were patient age 50 years or older (P = 0.03) and taking four or fewer core samples (P = 0.003). Needle core size did not impact accuracy or upgrade rates. Surgeons should exercise caution when interpreting needle biopsy results with older patients, smaller lesions, and limited sampling. Discordant pathology and imaging still mandate surgical confirmation. (10/2010) (link)
  • Olaya W, Bae W, Wong J, Roy-Chowdhury S, Kazanjian K, & Lum S. (2010). Accuracy and Upgrade Rates of Percutaneous Breast Biopsy: The Surgeon's Role. American Surgeon, 76(10), 1084-1087. We sought to evaluate the impact of needle core size and number of core samples on diagnostic accuracy and upgrade rates for image-guided core needle biopsies of the breast. A total of 234 patients underwent image-guided percutaneous needle biopsies and subsequent surgical excision. Large-core needles (9 gauge or less) were used in 14.5 per cent of cases and the remainder were performed with smaller core needles. More than four core samples were taken in 78.9 per cent of patients. In 71.8 per cent of cases, needle biopsy pathology matched surgical excision pathology. After surgical excision, upgraded pathology was revealed in 10.7 per cent of cases. Of 11 patients (52.4%) with benign needle core pathology who had upgraded final pathology on surgical excision, 10 had a Breast Imaging Recording and Data System score 4 or 5 imaging study. Lesions smaller than 10 mm were more likely to be misdiagnosed (P = 0.01) or have upgraded pathology (P = 0.009). Other predictors of upgraded pathology were patient age 50 years or older (P = 0.03) and taking four or fewer core samples (P = 0.003). Needle core size did not impact accuracy or upgrade rates. Surgeons should exercise caution when interpreting needle biopsy results with older patients, smaller lesions, and limited sampling. Discordant pathology and imaging still mandate surgical confirmation. (10/2010)