Diagnostic value of ultrasound-guided fine-needle aspiration biopsy, core-needle biopsy, and evaluation of combined use in the diagnosis of breast lesions1

Hatada, Takuya; Ishii, Hiromitsu; Ichii, Shigetoshi; Okada, Kaoru; Fujiwara, Yoshinori; Yamamura, Takehira

doi:10.1016/s1072-7515(99)00300-2

Cited by 92 publications

(65 citation statements)

References 23 publications

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“…11 Many authors have reported this limitations that can lead to incorrect or inconclusive results of FNAC. 4,6,12 Because of a wide range of inadequate rate of FNAC reported by other authors, we included in our study the inadequate cases in order to compare the methods. When the inadequate cases were excluded from the calculations, the accuracy of FNAC was falsely increased.…”

Section: Discussionmentioning

confidence: 99%

“…This results were similar to other authors suggesting that combined biopsy can improve the diagnosis of suspicious breast lesions. 4,6,12,15 For lesions smaller than 1 cm, FNAC, CNB, and combined biopsy were equivalent in diagnostic accuracy. The lower diagnostic accuracy of FNAC for lesions smaller than 1 cm reported by other authors were identified in our study.…”

Section: Aspiration Cytology and Core Needle Biopsymentioning

confidence: 99%

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A comparision of aspiration cytology and core needle biopsy according to tumor size of suspicious breast lesions

Barra

Gobbi

Rezende

et al. 2007

Diagnostic Cytopathology

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The purpose of the study was to compare the accuracy of FNAC, CNB, and combined biopsy according to tumor size of suspicious breast lesions.FNAC and CNB were performed in 264 patients with suspicious breast lesions from August, 1997 to August, 2002. The procedures were guided by ultrasound and performed in the same session by the same operator. The lesions were divided in four groups according to the tumor size in the histopathology report: lesions smaller than 1 cm, between 1 and 2 cm, between 2 and 5 cm, and lesions greater than 5 cm.The final surgical histopatology results identified 222 (84%) malignant cases and benign lesions summed 42 (16%). For lesions smaller than 1 cm, FNAC, CNB, and combined biopsy were equivalent for all parameters. For lesions between 1 and 2 cm, FNAC and CNB were equivalent. Combined biopsy showed higher absolute sensitivity (P ¼ 0.007) and lower inadequate rate (P ¼ 0.03) when compared to FNAC. However, when combined biopsy and CNB were compared, no difference were found. For lesions between 2 and 5 cm, CNB showed higher absolute sensitivity (P < 0.001) and lower inadequate rate (P < 0.007) when compared to FNAC. Combined biopsy showed higher sensitivity compared to FNAC and CNB alone (P < 0.05) in this group. For lesions greater than 5 cm, FNAC and CNB were equivalent for all parameters. Combined biopsy only showed higher absolute sensitivity (P ¼ 0.04) when compared with FNAC alone.The combination of FNAC and CNB can improve the diagnosis of suspicious breast lesions higher than 1 cm. However, for lesions smaller than 1 cm, our results showed no difference between FNAC, CNB, and combined biopsy, for these lesions any modality has technical limitations. Diagn. Cytopathol. Key Words: breast cancer; tumor size; fine-needle aspiration cytology; core biopsyThe role of fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in establishing the diagnosis of breast disease has been clearly demonstrated. Several studies have compared FNAC and CNB 1-5 with heterogeneous results. It is difficult to decide from published studies which method is preferred. Results may be influenced by patient selection, incidence of breast carcinoma in the population, availability of follow-up data, duration of follow-up, differences in biopsy technique, operator expertise, and interpretation of the results.6,7 Many published series are from academic centers and not from a general hospital setting. Calculations for accuracy are made in different ways sometimes reflecting the clinical effectiveness of the procedure, sometimes only evaluating the laboratory performance. Comparisons between series can only be made after recalculation. 7This study compares the results of FNAC and CNB according to the tumor size taken from the same lesion by the same operator in one session under ultrasound guidance. Materials and MethodsFNAC and CNB were performed in 264 patients with suspicious breast lesions from

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Section: Discussionmentioning

confidence: 99%

Section: Aspiration Cytology and Core Needle Biopsymentioning

confidence: 99%

A comparision of aspiration cytology and core needle biopsy according to tumor size of suspicious breast lesions

Barra

Gobbi

Rezende

et al. 2007

Diagnostic Cytopathology

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“…When both tests were performed clinically in palpable lesions, the sensitivity of FNAC varied from 90 to 98% and that of CB from 90 to 100%, with one study showing better sensitivity for FNAC than CB (Ballo and Sneige, 1996;Agarwal et al, 2003;Dennison et al, 2003). When both tests were performed under ultrasound guidance, some found the sensitivity of the FNAC to be equal to that of CB (Hatada et al, 2000;Westenend et al, 2001), whereas others showed CB to be better (Chuo and Corder, 2003). In 112 breast cancers from our symptomatic unit, FNAC did not provide useful additional information owing to CB correctly diagnosing nearly all cancers leaving little room for FNAC to improve upon the preoperative diagnosis rate (Pilgrim and Ravichandran, 2005).…”

Section: Discussionmentioning

confidence: 99%

Role of fine-needle aspiration cytology and core biopsy in the preoperative diagnosis of screen-detected breast carcinoma

2006

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Core biopsy (CB) has now largely replaced fine-needle aspiration cytology (FNAC) in the preoperative assessment of breast cancer in the UK. We studied the contribution of FNAC and CB in the preoperative diagnosis of screen-detected breast carcinoma. Data were prospectively collected on 150 840 women who underwent breast screening over a 4-year period from 1999 to 2003. Data on women who had both FNAC and CB taken from the same lesion preoperatively and in whom surgical excision of the lesion subsequently confirmed malignancy was analysed. In 763 cancers, FNAC was inadequate (C1) in 8% and benign (C2) in 10%. Most of these cases presented with microcalcification (25% were C1 or C2). Core biopsy was not representative (B1) or benign (B2) in 7%. The absolute and complete sensitivities were 65 and 82% for FNAC and 80 and 93% for CB in the diagnosis of cancer. Core biopsy was abnormal (B3 or above) in 86% of the cancers missed by FNAC and FNAC was abnormal (C3 or above) in 65% of those missed by CB. Core biopsy is better than FNAC at preoperative diagnosis of screen-detected breast cancer as it missed fewer cancers. However, combining FNAC resulted in a better preoperative diagnosis rate. The National Health Service Breast Screening Programme (NHSBSP) was introduced in the United Kingdom in 1987, following publication of the findings of an expert committee the previous year. At present, all women aged 50 -70 years are offered two-view screening mammography every 3 years. Patients with radiologically suspicious lesions are recalled for further assessment that may include clinical examination, special mammographic views, ultrasound and collection of tissue for pathological assessment by fine-needle aspiration cytology (FNAC), core biopsy (CB), or more recently, by wide bore vacuum biopsy.In the early stages of NHSBSP, FNAC was the test used in the assessment. Core biopsy was introduced in the assessment process in late 1990s. The experience with this technique has improved considerably and CB is now considered to be the standard. The preoperative diagnosis rate of screen-detected carcinoma has been improving with increasing use of CB. Correspondingly, the use of FNAC is in decline and a number of screening units in the UK have abandoned it completely (Britton et al, 1997).At the Bedfordshire and Hertfordshire Breast Screening Unit, CB was introduced in the assessment of screen-detected breast lesions in 1997, but we continued to perform FNAC in addition in the majority of patients with suspicious lesions. The aim of this study was to assess the performance of FNAC and CB in the preoperative diagnosis of screen-detected breast carcinoma. MATERIALS AND METHODSData were prospectively collected on all women who attended the Bedfordshire and Hertfordshire Breast Screening Unit, England. We reviewed a 4-year period from April 1999 to March 2003. This period was chosen to ensure that operators had gained sufficient expertise in the use of CB, which was introduced in 1997. We selected, for detailed analysis, the women who had ...

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“…The overall sensitivity and specificity of FNAC and CNB in the classification of breast lesions depend on the radiological and histological features and on specific variables intrinsic to the technique. In most cases, CNB has both higher sensitivity and specificity than FNAC in diagnosing benign and malignant lesions (18)(19)(20)(21). However, as reported by Willems et al, the studies which reported high sensitivity (97.1%), specificity (99.1%), PPV (99.3%) and NPV (96.2%) included only definitive benign and malignant lesions and excluded the atypical and suspicious categories (21,22 …”

confidence: 96%

Comparison between fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) in the diagnosis of breast lesions

Moschetta¹,

Telegrafo²,

Da³

et al. 2014

GCHIR

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IntroductionBreast cancer still represents the leading tumor among women and the incidence of the disease is rising all over the world (1, 2). The risk of developing breast cancer is related to a number of factors including the events of reproductive life and lifestyle factors that modify endogenous levels of sex hormones. Diet has been also found to play an important role in the etiology of breast cancer.Mammography represents the most used modality for breast cancer screening, with mortality reduction of 30-40% in screened population (3, 4). However, its sensitivity is decreased in young women with radiologically dense breast (5). Another limitation of planar mammography is represented by the two-dimensional visualization of a three-dimensional volumetric structure such as the breast, with a consequent superimposition of tissue. These limitations are partially solved by the full-field digital mammography (FFDM), with its improved dynamic range, tissue contrast and post-processing, and by the digital breast tomosynthesis (DBT), which partially addresses the two-dimensional breast representation of planar mammography (4). Dual-energy contrast enhanced digital mammography represents a novel technique and has a reported sensitivity of 93% versus 78% of conventional mammography alone (6).With the recent advances in technology, US and MRI allow to delineate occult malignancy in women with dense breast tissue, especially in case of high risk patients (5,7,8).Recently, nuclear medicine imaging technology has been introduced in the field of breast cancer with the development of positron emission tomography (PET), PET- Aim. To compare the diagnostic accuracy of fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in patients with USdetected breast lesions.Patients and methods. KEY WORDS: Breast -Fine-needle aspiration cytology -Core needle biopsy -FNAC -CNB.

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Diagnostic value of ultrasound-guided fine-needle aspiration biopsy, core-needle biopsy, and evaluation of combined use in the diagnosis of breast lesions1

Cited by 92 publications

References 23 publications

A comparision of aspiration cytology and core needle biopsy according to tumor size of suspicious breast lesions

A comparision of aspiration cytology and core needle biopsy according to tumor size of suspicious breast lesions

Role of fine-needle aspiration cytology and core biopsy in the preoperative diagnosis of screen-detected breast carcinoma

Comparison between fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) in the diagnosis of breast lesions

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