Abstract
Large-core needle biopsy (LCNB) is a common diagnostic tool used for breast lesions biopsy under free-hand or ultrasound guidance. In this paper, we have retrospectively studied on 1,431 patients who require histopathological diagnosis of breast lesions by LCNB in Tianjin Cancer Hospital from January 2008 to April 2009. The procedure used automated prone unit, biopsy gun, and 14-gauge or 16-gauge needle under free-hand or ultrasound guidance. The pathological diagnosis and classification (12 features) were independently evaluated by pathologists. The pathological findings showed that 989 (69.1%) was invasive carcinoma, 58 (4.1%) were ductal carcinoma in situ (DCIS), 20 (1.4%) were diagnosed as atypical ductal hyperplasia (ADH), and 124 cases were benign masses. The diagnostic accuracy, sensitivity, and specificity were 0.89, 0.88, and 0.98, respectively. This study suggested that LCNB is a useful histological technique for diagnosing invasive cancer, but may not be inaccurate in diagnosis of ADH and DCIS. For the latter, surgical excision may be necessary.
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Abbreviations
- LCNB:
-
Large-core needle biopsy
- CB:
-
Core biopsy
- FNA:
-
Fine-needle aspiration biopsy cytology
- ADH:
-
Atypical ductal hyperplasia
- DCIS:
-
Ductal carcinoma in situ
- ILC:
-
Invasive lobular carcinoma
- IDC:
-
Invasive ductal carcinoma
References
Usami S, Moriya T, et al. Pathological aspects of core needle biopsy for non-palpable breast lesions. Breast Cancer. 2005;12(4):272–8.
Schueller G, Schueller-Weidekamm C, Helbich TH. Accuracy of ultrasound-guided, large-core needle breast biopsy. Eur Radiol. 2008; 18(9):1761–73. Ann Pathol. 2003; 23(6):496–507.
Altman DG, Bland JM. Diagnostic tests. 1: sensitivity and specificity. BMJ. 1994;308(6943):1552.
Rotten D, Levaillant JM, Leridon H, et al. Ultrasonographically guided fine needle aspiration cytology and core needle biopsy in the diagnosis of breast tumors. Eur J Obstet Gynecol Reprod Biol. 1993;49:175–86.
Fajardo LL, Pisano ED, Caudry DJ, Gatsonis CA, Berg WA, Connolly J, et al. Radiologist investigators of the radiologic diagnostic oncology group V: stereotactic and sonographic large-core biopsy of non-palpable breast lesions. Results of the radiologic diagnostic oncology group V study. Acad Radiol. 2004;11:293–308.
Brenner RJ, Basset LW, Fajardo LL, Dershaw DD, Evans WP III, Hunt R, et al. Stereotactic core needle breast biopsy: a multi-institutional prospective trial. Radiol. 2001;218:866–72.
Verkooijen HM. Core biopsy after radiological localisation (COBRA) study group: diagnostic accuracy of stereotactic large-core needle biopsy for nonpalpable breast disease. Result of a multicenter prospective study with 95% surgical confirmation. Int J Cancer. 2002;99:853–9.
Masood S. Core needle biopsy versus fine needle aspiration biopsy: are there similar sampling and diagnositic issues? Clin Lab Med. 2005;25:679–88.
Roger J, Kent W, Michael J, et al. Stereotaxic large-core Needle Biopsy of 450 nonpalpable breast lesions with surgical correlation in lesions with cancer or atypical hyperplasia. Radiology. 1994;193:91–5.
Jackman R, Burbank F, Parker S, Evans W, Lechener MC, Richardson T, et al. Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates. Radiology. 2001;218:497–502.
Nath ME, Robinson TM, Tobon H, Chough DM, Sumkin JH. Automated large-core needle biopsy of surgically removed breast lesions: comparison of samples obtained with 14-, 16-, and 18-gauge needles. Radiology. 1995;197:739–42.
Brenner RJ, Fajardo L, Fisher PR, Dershaw DD, Evans WP, Bassett L, et al. Percutaneous core biopsy of the breast. Effect of operator experience and number of samples on diagnostic accuracy. Am J Roentgenol. 1996;166:341–6.
Rich PM, Michell MJ, Humphreys S, Howes GP, Nunnerley HB. Stereotactic 14G core biopsy of non-palpable breast cancer. What is the relationship between the number of core samples taken and sensitivity for detection of malignancy? Clin Radiol. 1999;54:384–9.
Silverstein MJ, Cohlan BF, Gierson ED, et al. Duct carcinoma in situ: 227 cases without microinvasion. Eur J Cancer. 1992;28:630–4.
Liberman L, Evans WP III, Dershaw DD, et al. Radiography of microcalcifications in stereo-taxic mammary core biopsy specimens. Radiology. 1994;190:223–5.
Acknowledgments
We thank Professor Jing-Fei Dong (Baylor College of Medicine, Houston, USA) for manuscript revision. This work was supported by Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China.
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Wei, X., Li, Y., Zhang, S. et al. Experience in large-core needle biopsy in the diagnosis of 1431 breast lesions. Med Oncol 28, 429–433 (2011). https://doi.org/10.1007/s12032-010-9494-3
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DOI: https://doi.org/10.1007/s12032-010-9494-3