Core needle biopsy (CNB) as a diagnostic method for breast lesions: Comparison with fine needle aspiration cytology (FNA)

Abstract

In Japan, fine needle aspiration biopsy (FNA) of the breast has long been recognized as a useful diagnostic tool, and has been used in many institutions because it provides a rapid, accurate and cost-effective evaluation. However, the use of core needle biopsy (CNB) is increasing, and vacuum assisted biopsy devices have been developed to produce larger specimens for analysis. CNB is useful because the frequency of inadequate specimens is lower than in FNA, and it requires a less invasive procedure than open biopsy. CNB is also more widely used, compared to FNA, because it can provide a more definitive diagnosis of borderline lesions and can be used to distinguish between IDC and ILC. Therefore, the use of CNB with mammographic or ultrasonographic guidance is especially high for non-palpable tumors. FNA is a rapid and non-invasive procedure that is useful for mass lesions. The accuracy of FNA for non-palpable lesions is relatively low, and depends upon the skill of the aspirators, cytoscreeners and cytopathologists involved in the procedure. However, FNA for palpable masses, coupled with a physical and mammographic examination (the so-called triple test) is highly accurate for diagnosis of breast cancer when all three modalities indicate malignancy, and for a benign lesion when all three are negative.

Comparative study of core needle biopsy and fine needle aspiration cytology in palpable breast lumps: scenario in developing nations

“…B3 (Benign, but of uncertain malignant potential) category had only a single case as compared to the C3 category of FNaC that had 35 cases. This implies that the lesions diagnosed as borderline or suspicious (C3, C4) on FNaC should be confirmed by a biopsy, either open biopsy or minimally invasive core biopsy, a view also supported by other authors (11,(17)(18)(19)(20)(21)(22)(23)(24). Besides, none of the cases placed in the B2 category were found out to be malignant on FNaC/histopathology.…”

Cytohistological correlation and discrepancy of conventional Papanicolaou smear test with corresponding histopathology: a retrospective study over a 5-year period

“…Furthermore, it is noteworthy that tissue interpretation is easier than cytology preparations (24). The absence of specialized cytopathologists for the diagnosis of cervical lesions may contribute to the discrepancy.…”

A Study of Triple Assessment of Breast Cancer Patients in a Tertiary Care Hospital of Central India

“…FNAC is a useful diagnostic tool because it is rapid and cost effective. 18 In conclusion, the mean age of presentation for breast carcinoma is a decade earlier in our patients compared to patients from the west. Hence, mammography as a screening tool is less likely to be as effective, due to the following reasons.…”