Statistical Evaluation Overview of the last years

Dr. Daniela Schwegler Kantonsspital Aarau

MIBB-Register

• Change from an Excel sheet to internet-based file www.adjumed.net

• Constant revisions & updates • Check of qualifications of centers and

operators • Annual evaluations (centers and pool)

Publications • J.C. Rageth et al: 2nd international conference on lesions of uncertain

malignant potential in the breast(B3): Breast Cancer Research and Treatment (2019) 174:279-296

• J.C. Rageth et al: First International conference on lesions of uncertain malignant potential in the breast (B3 lesions): Breast Cancer Res Treat; First Online: 13 August 2016

• C. Kurtz et al: Konsensus-Guidelines für die Durchführung von MRT-gestützten Vakuumbiopsien der Schweizer Gesellschaft für Senologie (SGS) – erarbeitet durch die MIBB Arbeitsgruppe Interdisciplinary Consensus Guidelines on the Use of MR-Supported Vacuum Biopsies of the Swiss Society of Senology (SGS) – Developed by the MIBB Working Group: Senologie – Zeitschrift für Mammadiagnostik und -therapie 2014; 11(3): 143-152.

• Imschweiler T. et al: MR-guided vacuum-assisted breast biopsy: Eur Radiol 2014 Jan;24(1): 128-35

• Saladin C. et al: Histopathologically B3 lesions: ECR 2013 Wien (EPOS)

MIBB-Register: Limitations

• Incomplete Data • People not entering their data! • Multiple choices & double choices (

>100%)

VAB total

0

500

1000

1500

2000

2500

3000

3500

4000

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

2981

3478 3448 3249

3669

3319

3589 3437

3137 3064

VAB total: 33371

VAB total

Aim of MIBB

85.05%

6.85%

7.97%

2018

diagnostic

therapeutic

mixed

Indications

57.42

3.07

15.02

14.75

0.58 5.38 3.62

2018

Microcalcification

Ach.distort.

MRI-Lesion

US-Lesion

MG-Asymm.

MG-Density

others

Indikations over the years

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

others

MG-Density

MG-Asymm.

US-Lesion

MRI-Lesion

Ach.distort.

Microcalcification

Methods over the years %

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

57.61 56.48 58.76 62.8 60.78

47.98

38.95 34.67

30.73 24.61

31.63 30.56 24.44 20.12

18.63

19.26

19.03

18.66 19.29

20.1

4.21 5.63 8.49 10.24

8.3

10.03

10.62 12.25

11.67 14.43

6.18 7.13 8.2 6.81 9.88

6.84

8.11 7.12

9.36 7.77

0 0 0 0.03 2.41

15.41 23.15

27.09 28.28 32.67

others

Tomosynth.

stereo-upright

MR-guided

US-guided

stereo-prone table

Is there a change in the method/aim over the years?!

1094

300 387

237

920

diagnostic 2016

prone table

US-guided

MR-guided

upright

Tomo

2047 263

307 344

88

diagnostic 2013

prone table

US-guided

MR-guided

upright

Tomo

There is a change!

therapeutic 2016

prone table

US-guided

MR-guided

upright

Tomo

therapeutic 2013

prone table

US-guided

MR-guided

upright

Tomo

Which aim with which Method

0 200 400 600 800 1000 1200

prone table

US-guided

MR-guided

upright

Tomo

diagnostic 2016

therapeutic 2016

both 2016

Which needle for which Method

0

1000

2000

3000

4000

5000

6000

7000

Tomo

upright

MR-guided

US-guided

prone Table

MG-BI-RADS %

0

10

20

30

40

50

60

no MG BI-RADS 0 BI-RADS 1 BI-RADS 2 BI-RADS 3 BI-RADS 4 BI-RADS 5

9.11

3.07

7.6 6.04

11.55

59.17

3.39

2018

Number of specimen

0

5

10

15

20

25

30

35

40

45

50

1-5 6-10 11-15 16-20 21-25 26-30 >30

B-Classification in %

0

10

20

30

40

50

60

B1 B2 B3 B4 B5a B5b B5c B5d unbekannt

0.92

54.35

18.14

0.41

13.23

6.92

0.22 0.16 3.67

2018

Histology in %

0.56

0.21 1.04

1.89 0.53

51.07

6.6

2.51

5.18

4.17

0.98 1.69

4.05

8.55

7.28 2.28

2018

none

Phylloides

ALH (LN1)

ALH (LN2)

ALH (LN3)

benign

papillary L.

radial scar

FEA

ADH

DCIS

DCIS 1+2 (Low/high)

DCIS 1

DCIS 2

DCIS 3

inv. Ca

not representative

B-Classification / Method 2013-2016 Stereotaxie

B1

B2

B3

B4

B5

2013-2016 US

B1

B2

B3

B4

B5

2013-2016 MR

B1

B2

B3

B4

B5

2013-2016 Tomo

B1

B2

B3

B4

B5

Is the Biopsy representative?

94.58%

1.82%

0.86%

0.70%

2018

representative

in doubt

not representative

others

Recommendations

59.52%

29.49%

0.70% 7.94%

2018

follow up

surgery

repeat MIBB

others

Complications are rare

94.59

2.58

2018

keine

haemorrhage w/o I.

haemorrhage w. I.

missed Lesion

Infection

techn. Complication

not reproductible

not reachable

abortion

Questions???