Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

Is There A Correlation Between the Grip Strength and the Interosseous Muscles/Intermetacarpal Fat Pads of the Hand?: An Ultrasonographic Study

Objective: To investigate the correlation of the grip strength with sonographic measurement of interosseous muscles (IM) and the intermetacarpal fat pads (IMFP) of the hand.Material and Methods: A total of 40 healthy volunteers (mean age: 39±12 years, all female) were examined. Hand strength was assessed by the Jamar hand dynamometer. IM and IMFP thickness and width for both hands (n:80) were measured sonographically at four levels (1th, 2nd, 3rd and 4th intermetacarpal; palmar side for IM) and at three levels (2nd, 3rd and 4th intermetacarpal; dorsal side for IMFP).Results: The mean grip strength was 40±12 pounds (range: 20-67). Mean values (thickness x width) for IM were 20.7±2.1×9.9±1.2 mm, 9.0±1×10.3±0.9 mm, 7.3±1.0×9.9±1.0 mm, 8.5±1×9.5±0.9 mm at four levels, respectively. Mean values (thickness x width) for IMFP were 9.9±1.2×5.3±0.7 mm, 8.5±0.9×5.4±0.7 mm and 9.0±1.2×4.7±0.7 mm at three levels, respectively. There was a positive correlation between the grip strength and the dimensions of IM and IMFP (p<0.05).Conclusions: To our knowledge, this is the first study evaluating the correlation of grip strength and the sonographic IM-IMFP measurements. Further research in study groups affected by clinical situations involving the hand, is necessary to reveal the role of IM and IMFP studies in evaluating the pathologies