Biópsia de fragmento em nódulos mamários suspeitos com até 10 mm

Abstract

Biópsia de fragmento em nódulos mamários suspeitos com até 10 mm Core biopsy in suspicious solid breast lesions up to 10 mm ); 49 casos malignos (54,4%) e um caso (1,2%) de material considerado inconclusivo. Essa paciente foi submetida à nova biópsia de fragmento sob controle ultra-sonográfico, dessa vez obtendo-se material conclusivo. Houve concordância entre os achados anatomopatológicos e imagenológicos em 89 dos casos. A sensibilidade da biópsia de fragmento para o diagnóstico do câncer de mama foi de 98,8% e a especificidade foi de 100%. COnClusões: os resultados obtidos pela biópsia de fragmento guiada pela ultra-sonografia em nódulos sólidos de até 10 mm nesse trabalho são semelhantes aos melhores resultados de qualquer tipo de biópsia na literatura. Portanto, nódulos menores que 10 mm podem ser abordados histologicamente pela biópsia de fragmento com segurança. AbstractPuRPOse: to evaluate the diagnostic efficacy of core needle biopsy in suspicious solid breast masses (Bi-Rads ™ 4 or 5) up to 10 mm. MethOds: this study was conducted on 83 women diagnosed with 90 suspicious solid lumps, all measuring up to 10 mm, identified by mammography (41), sonography (47) or palpation (two), who visited our clinic from September 2003 to January 2006. The lesions were biopsied with automatic device and 14 gauge needle (Bard, Corington, GA), all of them ultrasound guided. According to the pathological report, the biopsies were classified as true-positives, false-positives, true-negatives, and false-negatives. The sensitivity and specificity of ultrasound-guided core biopsy in breast masses up to 1 cm were calculated. Results: the mean patient age was 52.5 years, and the mean diameter of the lesions was 7.3 mm, ranging from 3 to 10 mm. The results yielded by the pathologist showed 40 benign lesions (44.4%), 49 malignant lesions (54.4%) and one case (1.1%) of inconclusive material. This patient was submitted to ultrasound guided core needle biopsy once again, this time with conclusive results. There was agreement between histology and radiology in 89 cases. Sensitivity of ultrasound guided core biopsy for the diagnosis of breast cancer was 98.8 % and specificity 100%. COnClusiOns: the results obtained by ultrasound-guided core biopsy in suspicious breast lesions up to 10 mm are comparable to the best results of any kind of biopsy in the literature. Therefore, even solid lesions smaller or equal to 10 mm can be safely evaluated pathologically by core biopsy. Palavras-chaveNeoplasias mamárias/patologia Neoplasias mamárias/ultra-sonografia Neoplasias mamárias/diagnóstico Biópsia KeywordsBreast neoplasms/pathology Breast neoplasms/ultrasonography Breast neoplasms/diagnosis Biopsy

Accurate diagnosis of breast lesions

“…Most lesions are satisfactorily diagnosed with core biopsy. (16) Vacuum biopsy rescues a fragment of the lesion by means of vacuum suction using 7G to 12G needles. (17) Both core biopsy and vacuum biopsy can be used in lesions smaller than 1.0 cm according to the individual case.…”

“…(21) In lesions of uncertain malignant potential or cases of inconclusive core biopsy, VAE is indicated. (1,16,18,21) Incisional or excisional surgical biopsy is currently reserved for cases of clinical-imaging-pathological disagreement or situations in which percutaneous methods cannot be performed because of unavailability or technical contraindication, such as risk of pneumothorax. (14) What is the pathology?…”