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Biopsy sampling of breast lesions: comparison of core needle- and vacuum-assisted breast biopsies

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Abstract

Needle biopsy is now the initial investigation of choice for the pre-operative diagnosis of breast lesions. This includes core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) with or without radiologic assistance. The performance indices of both of these biopsy techniques were evaluated. In a large cohort of patients with breast lesions including 464 cases (285 CNB and 179 VAB), with confirmed outcomes, the diagnostic accuracy was compared using parameters including quantitation of the sampling based on the total number of cores taken, cores containing breast parenchyma, and cores with lesion; and non-epithelial changes including necrosis and calcification. CNB showed a 99% PPV, 94% NPV, 96% sensitivity, and 99% specificity, whereas VAB demonstrated a 100% PPV, 100% NPV, 100% sensitivity, and 100% specificity. The correct diagnosis in CNB was proportional to the number of cores extracted, whereas accuracy of VAB was independent of the total number of cores taken. There was a positive correlation between the presence of calcification and malignancy in CNB, but not detected under VAB. CNB and VAB were equally efficient in palpable lesions, in detecting necrosis, and calcification. Large calcification was found to be associated with malignancy in both CNB and VAB. In non-palpable lesions, VAB was more effective in the detection of calcification. The diagnostic accuracy of VAB appeared to be independent of number of cores sampled, whereas CNB required a minimum of 3–4 cores to achieve high diagnostic accuracy.

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Conflicts of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Authors and Affiliations

  1. Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, Hong Kong, People’s Republic of China

    Maribel D. Lacambra, Christopher C. Lam, Paulo Mendoza, Alex M. Yu, Julia Y. S. Tsang & Gary M. Tse

  2. Department of Pathology, Kwong Wah Hospital, Hong Kong, People’s Republic of China

    Siu Ki Chan

  3. Department of Pathology, Singapore General Hospital, Singapore, Singapore

    Puay Hoon Tan

Authors
  1. Maribel D. Lacambra
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  2. Christopher C. Lam
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  3. Paulo Mendoza
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  4. Siu Ki Chan
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  5. Alex M. Yu
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  6. Julia Y. S. Tsang
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  7. Puay Hoon Tan
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  8. Gary M. Tse
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Correspondence to Gary M. Tse.

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Lacambra, M.D., Lam, C.C., Mendoza, P. et al. Biopsy sampling of breast lesions: comparison of core needle- and vacuum-assisted breast biopsies. Breast Cancer Res Treat 132, 917–923 (2012). https://doi.org/10.1007/s10549-011-1639-3

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  • DOI: https://doi.org/10.1007/s10549-011-1639-3

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