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

Verkooijen, H.; Ph, Peeters; Buskens, E; Vc, Koot; Ih, Borel Rinkes; Mali, WP; Tj, van Vroonhoven

doi:10.1054/bjoc.1999.1036

Cited by 132 publications

(69 citation statements)

References 27 publications

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“…Assuming a breast cancer prevalence of 70-80% (BI-RADS 5), the false-negative rate would be 6%. 27 Low false-negative rate may be related to just the BI-RADS 4 lesion group that was included in our study. Newer technologies should be assessed with respect to their accuracy, safety and costeffectiveness.…”

Section: Discussionmentioning

confidence: 88%

Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound

Sarıca¹,

Uluc²

2014

BJR

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Objective: Biopsy has long been the standard approach in Breast Imaging Reporting and Data System® (BI-RADS) 4 or BI-RADS 5 (American College of Radiology, Reston, VA) lesions despite a wide variation in reported incidence of malignancy in BI-RADS 4 lesions. This study examined the diagnostic value of breast MRI as well as its ability to decrease unnecessary biopsies in patients with solid breast lesions who had an indication for biopsy. Methods: In this retrospective study, 277 breast lesions with a documented histological diagnosis as established by ultrasound-guided biopsy were included. All patients were female, and biopsy was performed owing to a BI-RADS score of 4 or 5 on ultrasonography. In addition, all patients had undergone MRI before biopsy. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI in predicting malignancy were calculated.Results: When all lesions were analysed, sensitivity, specificity, NPV and PPV of MRI in detecting malignancy were 94.2%, 56.1%, 90.7% and 68.1%, respectively. When only ultrasonographic BI-RADS 4 lesions are considered, the corresponding figures were as follows: 90.9%, 56.7%, 93.8% and 46.4%, respectively. False-negative rate of MRI for the latter group of lesions was 2.6%. 42% of unnecessary biopsies were avoided in sonographic BI-RADS 4 lesions. Conclusion: Despite promising results obtained in this study, dynamic MRI currently does not seem to be effective in ruling out the need for biopsy in the assessment of sonographic BI-RADS 4 lesions. However, advanced MRI techniques may assist in improving possible benefits of MRI in this patient group.

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Section: Discussionmentioning

confidence: 88%

Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound

Sarıca¹,

Uluc²

2014

BJR

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“…In each patient, SLCNB was followed by surgical excision (wire localised excision biopsy for nonmalignant lesions, breast conserving treatment or mastectomy for malignant lesions) to compare the initial diagnosis with that of the gold standard. The sensitivity and specificity of the new technique were 97 and 99%, respectively, and thus are comparable to surgical biopsy [11][12][13].…”

Section: Introductionmentioning

confidence: 65%

“…Specifically, the risk of finding cancer despite a benign diagnosis on SLCNB increases when the prevalence of carcinoma is higher in the population under study (examined), resulting in a higher false negative rate [12]. Before applying test results to a new (sub)population, the prevalence of breast cancer should be assessed.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Large Core Needle Biopsy for All Nonpalpable Breast Lesions?

Hoorntje

Peeters

Rinkes

et al. 2002

Breast Cancer Res Treat

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SummaryBackground. 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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“…TCB meme lezyonlarını araştırmada günümüzde en yaygın kullanılan yöntemdir (4,6). Tanısal olmayan TCB oranları tecrübeli ellerde %1 civarında veya daha azdır (7).…”

Section: Tartişma Ve Sonuçunclassified

“…TCB ile açık biyopsiden farklı olarak, lenfatikler sağlam kaldığı için sentinal lenf nodülü haritalama ve meme koruyucu ameliyat yapma olasılığı artar (5). Ayrıca TCB malignite tespit edildiğinde kanseri kategorize etmeye ve reseptör çalışmalarına da imkan vermektedir (6).…”

Section: Introductionunclassified

Ultrasonography-guided coaxial trucut biopsy at breast masses: Our clinical experience

İmamoğlu¹,

Imamoğlu²,

Adıbelli³

et al. 2018

Acta Oncol Tur.

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ÖZET GİRİŞ ve AMAÇ: Bu çalışmada girişimsel radyoloji ünitemizde US kılavuzluğunda yaptığımız koaksiyel meme TCB sonuçlarını ve tanısal değerini retrospektif olarak güncel literatür ışığında gözden geçirdik. YÖNTEM ve GEREÇLER: Çalışmamıza toplam 343 hasta dahil edildi. Lezyonlar breast imaging reporting and data system (BI-RADS) kullanılarak ultrasonografik olarak BI-RADS 3, BI-RADS 4 ve BI-RADS 5 olarak kategorize edildi. Tüm lezyonlardan 18 G tam otomatik TCB iğnesi ile multipl biyopsiler alındı. İstatistiksel analiz, SPSS version 18.0 ile yapıldı. BULGULAR: Histopatolojik inceleme sonrası lezyonların 129 tanesi malign, 214 tanesi ise benign olarak tespit edildi. Kitlelerin en sık yerleşim yeri 162 lezyon ile meme üst dış kadranıydı. Retroareolar yerleşimli lezyonların benignide yönünden istatistiksel olarak anlamlı olduğu görüldü. Radyolojik değerlendirmede lezyonların % 39,1 BIRADS 3, % 33,2 BIRADS 4 ve % 27,7 BIRADS 5 olarak sınıflandırıldı. BIRADS 3 lezyonlarda benignide için ultrasonografinin pozitif prediktif değeri % 100 olarak hesaplandı. BIRADS 4 lezyonlarda malignite için ultrasonografinin pozitif prediktif değeri % 29,8 olarak hesaplandı. BIRADS 5 lezyonlarda malignite için ultrasonografinin pozitif prediktif değeri %100 olarak değerlendirildi. TARTIŞMA ve SONUÇ: Bizim çalışmamızda tanısal yetersiz TCB mevcut değildi. Ultrasonografik olarak 134 olgu BIRADS 3 tanısı almıştı ve hepsi benign olarak raporlandı. Bu bulgu BIRADS-3 lezyonları takip yönünden cesaretlendirmektedir. Çalışmamızda BIRADS 4 lezyonların % 29,8'i malign tanı aldı. Bununla birlikte bu grup lezyonların büyük kısmını benign lezyonlar oluşturmaktadır. Bu durum gereksiz biyopsileri beraberinde getirmekle birlikte BIRADS 4 lezyonlarda TCB endikasyonuna neden olmaktadır. BIRADS 5 olarak yorumlanan 95 olgunun tümü de malign tanı almıştır. Bu nedenle BIRADS 5 lezyonlara mutlaka TCB yapılmalıdır. Sonuç olarak meme lezyonlarının US ile sınıflandırılması ve ultrasonografi kılavuzluğunda yapılan koaksiyel TCB, hızlı uygulanan, hızlı sonuç alınan, hastaya fazla rahatsızlık vermeden daha güvenilir preoperatif planlamaya olanak sağlayan etkin bir yöntemdir. Anahtar Kelimeler: ultrasonografi, BI-RADS, koaksiyel trucut biyopsi, ABSTRACT INTRODUCTION:In this study, we retrospectively reviewed the results and diagnostic value of the US guided coaxial breast TCB with current literature. METHODS: A total of 343 patients were included in the study. The lesions were categorized as BI-RADS 3, BI-RADS 4 and BI-RADS 5 by using breast imaging reporting and data system (BI-RADS). Multiple biopsies were obtained from all lesions with coaxial fully automated TCB needle. Statistical analysis was performed with SPSS version 18.0.

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

Cited by 132 publications

References 27 publications

Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound

Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound

Stereotactic Large Core Needle Biopsy for All Nonpalpable Breast Lesions?

Ultrasonography-guided coaxial trucut biopsy at breast masses: Our clinical experience

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