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Diagnostic value of fine needle aspiration and core needle biopsy in special types of breast cancer

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Abstract

Background

Although fine needle aspiration (FNA) biopsy is an established tool to assess breast lesions, there has been a trend toward using core needle biopsy (CNB) instead. The aim of this study was to compare the diagnostic accuracy of FNA and CNB in special types of breast cancer.

Methods

A retrospective review of diagnostic results of pre-operatively performed FNA or CNB, or a combination of the two, was conducted. The cases include histologically proven invasive ductal carcinoma of no special type (NST n = 159), invasive lobular carcinoma (ILC n = 65), mucinous carcinoma (MUC n = 51), and apocrine carcinoma (APO n = 25).

Results

The absolute diagnostic sensitivity of FNA to detect malignancy in ILC and APO patients was inferior to that of NST patients (p < 0.001 for ILC and APO). Within each cancer type, the sensitivity of CNB was higher than that of FNA in the ILC and APO patients (p < 0.001 and p < 0.05, respectively). As for NST and MUC patients, FNA and CNB had equivalent sensitivity. The sensitivity of FNA alone significantly improved when combined with CNB in NST, ILC and APO patients (p < 0.05, p < 0.001, and p < 0.05, respectively).

Conclusions

Our results suggest that FNA has less diagnostic accuracy than CNB for ILC and APO; thus, the use of CNB should be encouraged when these types of cancer are clinically suspected or when the initial FNA is inconclusive.

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Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Ryuji Ohashi, Miyuki Matsubara, Yasuhiko Watarai, Shin-ichi Tsuchiya & Zenya Naito

  2. Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan

    Keiko Yanagihara, Koji Yamashita & Hiroyuki Takei

  3. Department of Diagnostic Pathology, Iida Hospital, Nagano, Japan

    Shin-ichi Tsuchiya

  4. Department of Pathology and Integrative Oncological Pathology, Nippon Medical School, Tokyo, Japan

    Zenya Naito

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  1. Ryuji Ohashi
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  2. Miyuki Matsubara
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  3. Yasuhiko Watarai
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Correspondence to Ryuji Ohashi.

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Ohashi, R., Matsubara, M., Watarai, Y. et al. Diagnostic value of fine needle aspiration and core needle biopsy in special types of breast cancer. Breast Cancer 23, 675–683 (2016). https://doi.org/10.1007/s12282-015-0624-9

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  • DOI: https://doi.org/10.1007/s12282-015-0624-9

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