Breast biopsy: a comparative study of stereotaxically guided core and excisional techniques.

Gisvold, JJ; Goellner, John R.; Grant, Clive S.; Donohue, John H.; Sykes, M. W.; Karsell, PR; Coffey, S. L.; Jung, Sin‐Ho

doi:10.2214/ajr.162.4.8140997

Cited by 199 publications

(130 citation statements)

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“…In four studies the percentage of lesions with microcalcifications was reported (Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997;Jackman et al, 1999) which varied from 21 to 48%. The malignancy rate varied from 23 to 57% and four studies reported that 9-40% of all malignant lesions was DCIS only.…”

Section: Resultsmentioning

confidence: 99%

“…This value may be overestimated due to the non-blindness of the pathologists (Irwig et al, 1994). In four studies large-core needle biopsy procedures as well as open biopsy procedures were performed on the same day (Parker et al, 1991;Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997). Therefore, pathologists may not have been blinded for the results of the reference standard test (open biopsy).…”

Section: Discussionmentioning

confidence: 99%

“…Stereotactic biopsy was performed with the patient in prone position by using a 14-gauge needle and a long throw biopsy gun. In four studies all histological diagnoses of large-core needle biopsy specimens were confirmed by additional open biopsy and generally these two procedures took place on the same day (Parker et al, 1991;Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997). In the study of Jackman et al (1999), 295 patients (61%) with a benign diagnosis on large-core needle biopsy did not undergo immediate open biopsy, but mammographic follow-up.…”

Section: Meta-analysis Of Diagnostic Accuracymentioning

confidence: 99%

“…Twenty-five publications were comments, letters or review articles and in 50 studies, the diagnostic performance of large-core needle biopsy was not the object of study. Of the 43 publications addressing the diagnostic accuracy of large-core needle biopsy, five publications were included in the meta-analysis (Parker et al, 1991;Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997;Jackman et al, 1999). (A list of the 38 excluded publications and the reasons for exclusion is available upon request.)…”

mentioning

confidence: 99%

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Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

Verkooijen¹,

Buskens

et al. 2000

Br J Cancer

132

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For the evaluation of non-palpable lesions of the breast, image-guided large-core needle biopsies are increasingly replacing needle-localized open breast biopsies. In this study, the diagnostic accuracy of this minimally invasive technique was evaluated by reviewing the available literature. Five cohort studies were included in a meta-analysis. Sensitivity rate, histological agreement between needle biopsy and subsequent surgery or long-term mammographic follow-up and clinical consequences for different disease prevalences were assessed. The sensitivity rate of large-core needle biopsy for the diagnosis of breast cancer was high (97%). The reclassified agreement rate between core biopsy and subsequent surgical biopsy or long-term mammographic follow-up was also high (94%). In case of 20% breast cancer prevalence among women referred after screening (as in the US), the risk of breast cancer despite benign large-core needle biopsy result is less than 1%. In European countries, however, prevalence of breast cancer among referred women is 60–70%. This would result in a risk of breast cancer despite benign large-core needle biopsy result of 4–6%. The results of this meta-analysis indicate that the image guided large-core needle biopsy is a promising alternative for the needle localized breast biopsy. However, additional research is needed to explore the limiting factors of the technique. Without such detailed knowledge, a benign histological diagnosis on large-core needle biopsy in countries with high prevalence of malignancy among referred women should be interpreted with caution. © 2000 Cancer Research Campaign

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Meta-analysis Of Diagnostic Accuracymentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

Verkooijen¹,

Buskens

et al. 2000

Br J Cancer

132

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“…This SNUH dataset of 74 patients was used to develop a prediction algorithm for histologic underestimation. The definition employed for ''histologic underestimation'' was a lesion diagnosed as ADH at CNB that was revealed to harbor malignant foci at follow-up surgical excision, including ductal carcinoma in situ and invasive cancer [4,14]. The validation dataset consisted of 34 cases diagnosed with ADH at CNB that underwent subsequent surgical excision at the National Cancer Center, Korea …”

Section: Study Populationmentioning

confidence: 99%

Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy

Han

Lee

et al. 2007

Breast Cancer Res Treat

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Background The aim of this study was to determine factors that predict under-evaluation of malignancy in patients diagnosed with atypical ductal hyperplasia (ADH) at ultrasound-guided core needle biopsy (CNB), and to develop a prediction algorithm for scoring the possibility of a diagnosis upgrade to malignancy based on clinical, radiological and pathological factors. Methods The study enrolled patients diagnosed with ADH at ultrasound-guided CNB who subsequently underwent surgical excision of the lesion. Multivariate analysis was used to identify relevant clinical, radiological and pathological factors that may predict malignancy. Results A total of 102 patients with ADH at CNB were identified. Of the 74 patients who underwent subsequent surgical excision, 34 (45.8%) were diagnosed with invasive or in situ malignant foci. Multivariate analysis revealed that age [50 years, microcalcification on mammography, size on imaging [15 mm and a palpable lesion were independent predictors of malignancy. Focal ADH was a negative predictor. A scoring system was developed based on logistic regression models and beta coefficients for each variable. The area under the ROC curve was 0.903 (95% CI: 0.82-0.94), and the negative predictive value was 100% for a score B3.5. Similar findings were observed for a validation dataset of 54 patients at other institutions. Conclusions A scoring system to predict malignancy in patients diagnosed with ADH at CNB was developed based on five factors: age, palpable lesion, microcalcification on mammography, size on imaging and focal ADH. This system was able to identify a subset of patients with lesions likely to be benign, indicating that imaging follow-up rather than surgical excision may be appropriate.

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Breast Biopsy Utilization

Ghosh

Melton²,

Suman³

et al. 2005

Arch Intern Med

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This population-based study provides much-needed data regarding the frequency of breast biopsies and benign results of breast biopsies in a community population. The utilization rate of breast biopsies remained fairly constant throughout the study period despite the introduction of the image-guided, core-needle biopsy procedure in 1992. A multidisciplinary breast practice, along with established guidelines for breast biopsy, can ensure appropriate use of new technology and thereby improve patient care.

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Breast biopsy: a comparative study of stereotaxically guided core and excisional techniques.

Cited by 199 publications

References 0 publications

Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy

Breast Biopsy Utilization

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