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Stereotactic Large Core Needle Biopsy for All Nonpalpable Breast Lesions?

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Abstract

Background Stereotactic large-core needle biopsy (SLCNB) is a minimally invasive method for histological diagnosis of nonpalpable breast disease. We studied differences in cancer prevalence between a group of women referred through the national screening program and a non-screening group, and assessed whether the validity of SLCNB differed between these groups.

Methods A group of non-selective, consecutive patients presenting with a nonpalpable mammographic lesion, who participated in a recently conducted multicenter study regarding the accuracy of SLCNB in The Netherlands, were the basis for this study. Prevalence of carcinoma, predictive value of a benign diagnosis, sensitivity, and specificity rate of SLCNB were compared between the two groups.

Results Of the 1029 lesions in 972 patients included, 858 were evaluable. In 850/858 lesions (99.1%) the reason for referral was clear. The prevalence of cancer in the screening group (n = 511 lesions) was 64.0% (95%CI 59.8–68.2), versus 49.6% in the non-screening group (n = 339) (95%CI 44.2–54.9). Respective predictive values of a benign diagnosis on SLCNB were 97.0 versus 94.8% (non-significant). The sensitivity rates of SLCNB were 98.5% (screening; 95%CI 96.5–99.5) versus 95.2% (non-screening; 95%CI 90.8–97.9). Specificity rates were 97.8 (95%CI 94.5–99.4) and 99.4% (95%CI 96.8–100), respectively.

Conclusion Despite a significant difference in the prevalence of carcinoma, the accuracy of SLCNB did not show a statistically significant difference between both patient groups. Therefore, SLCNB appears accurate in diagnosing nonpalpable breast lesions both in screening and non-screening patient groups.

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Authors and Affiliations

  1. Department of Surgery, University Medical Centre, Utrecht, The Netherlands

    L.E. Hoorntje & I.H.M. Borel Rinkes

  2. Julius Center for Patient Oriented Research, University Medical Centre, Utrecht, The Netherlands

    P.H.M. Peeters

  3. Registre Genevois des Tumeurs, Institut de Méedecine Sociale et Préeventive, Universitée de Genèeve, Genèeve, Switzerland

    H.M. Verkooijen

  4. Department of Radiology, Martini Hospital Groningen, Groningen, The Netherlands

    R.M. Pijnappel

  5. Department of Radiology, University Medical Centre, Utrecht, The Netherlands

    W.P.Th.M. Mali

Authors
  1. L.E. Hoorntje
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  2. P.H.M. Peeters
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  3. I.H.M. Borel Rinkes
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  4. H.M. Verkooijen
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  5. R.M. Pijnappel
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  6. W.P.Th.M. Mali
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Hoorntje, L., Peeters, P., Rinkes, I.B. et al. Stereotactic Large Core Needle Biopsy for All Nonpalpable Breast Lesions?. Breast Cancer Res Treat 73, 176–181 (2002). https://doi.org/10.1023/A:1015289903352

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