Meta-analysis of the concordance of histological grade of breast cancer between core needle biopsy and surgical excision specimen

Knuttel, Floortje M.; Menezes, Gisela L. G.; Diest, Paul J. van; Witkamp, Arjen J.; Bosch, Maurice A.A.J. van den; Verkooijen, Helena M.

doi:10.1002/bjs.10128

Cited by 30 publications

(31 citation statements)

References 76 publications

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“…When assessing tumor grade on CNB and FUE, discordance rates did not differ more than one grade . Previous studies have reported underestimation of tumor grade on CNB to be up to 20% . In our study, the CNB was found to predict tumor grade and mitotic rate of IMCs in 82% of FUEs.…”

Section: Discussionsupporting

confidence: 58%

Correlation between invasive mammary carcinoma grade and size in ultrasound-guided core needle biopsy and subsequent surgical excision

et al. 2017

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The purpose of this study was to correlate the histologic grade, mitotic rate and size of invasive mammary carcinomas (IMC) on ultrasound (US) core needle biopsy (CNB) and the follow-up excision (FUE). The underestimation and overestimation of the grades by CNB were 11% and 8%. CNBs were more specific for grade 3 tumors. Tumors >10 mm by US examination showed greater concordance in grades. The size in the FUE was the best determinant of pT followed by US examination. The extent of IMC on CNB was larger than FUE in 8% resulting in pT upstaging in 3% of cases.

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Section: Discussionsupporting

confidence: 58%

Correlation between invasive mammary carcinoma grade and size in ultrasound-guided core needle biopsy and subsequent surgical excision

et al. 2017

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“…Previous studies showing that intertumoral metabolic heterogeneity is more pronounced than intratumoral metabolic heterogeneity (32) and that core biopsy samples can be used to reliably assess intertumoral differences (33)(34)(35)(36)(37) provided us with a rationale for comparing global imaging-based metrics (mean LAC/PYR and mean summed SNR LAC ) with the results from IHC and RNA sequencing of single tumor biopsies. The strong correlation between the LAC/PYR with tumor volume, which is known to correlate with hypoxia (38), led us to investigate the contribution of hypoxia to the measured lactate signal.…”

Section: Discussionmentioning

confidence: 99%

Imaging breast cancer using hyperpolarized carbon-13 MRI

Gallagher

Woitek

McLean

et al. 2020

Proc. Natl. Acad. Sci. U.S.A.

157

204

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Our purpose is to investigate the feasibility of imaging tumor metabolism in breast cancer patients using 13C magnetic resonance spectroscopic imaging (MRSI) of hyperpolarized 13C label exchange between injected [1-13C]pyruvate and the endogenous tumor lactate pool. Treatment-naïve breast cancer patients were recruited: four triple-negative grade 3 cancers; two invasive ductal carcinomas that were estrogen and progesterone receptor-positive (ER/PR+) and HER2/neu-negative (HER2−), one grade 2 and one grade 3; and one grade 2 ER/PR+ HER2− invasive lobular carcinoma (ILC). Dynamic 13C MRSI was performed following injection of hyperpolarized [1-13C]pyruvate. Expression of lactate dehydrogenase A (LDHA), which catalyzes 13C label exchange between pyruvate and lactate, hypoxia-inducible factor-1 (HIF1α), and the monocarboxylate transporters MCT1 and MCT4 were quantified using immunohistochemistry and RNA sequencing. We have demonstrated the feasibility and safety of hyperpolarized 13C MRI in early breast cancer. Both intertumoral and intratumoral heterogeneity of the hyperpolarized pyruvate and lactate signals were observed. The lactate-to-pyruvate signal ratio (LAC/PYR) ranged from 0.021 to 0.473 across the tumor subtypes (mean ± SD: 0.145 ± 0.164), and a lactate signal was observed in all of the grade 3 tumors. The LAC/PYR was significantly correlated with tumor volume (R = 0.903, P = 0.005) and MCT 1 (R = 0.85, P = 0.032) and HIF1α expression (R = 0.83, P = 0.043). Imaging of hyperpolarized [1-13C]pyruvate metabolism in breast cancer is feasible and demonstrated significant intertumoral and intratumoral metabolic heterogeneity, where lactate labeling correlated with MCT1 expression and hypoxia.

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“…We therefore do not expect that this influences the model validity. However, discrepancy of tumor grade between core needle biopsies and excision specimen was reported to be near 30% in a recent meta-analysis 36 . It may be that this discrepancy has influence on the performance of the model.…”

Section: Accepted Manuscriptmentioning

confidence: 98%

Validation and update of a lymph node metastasis prediction model for breast cancer

Qiu

Aarnink

Maaren

et al. 2018

European Journal of Surgical Oncology

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Meta-analysis of the concordance of histological grade of breast cancer between core needle biopsy and surgical excision specimen

Abstract: Grading on CNB corresponds moderately with grading based on excision specimens, with underestimation in about one in five patients. Incorrect CNB tumour grading has limited clinical implications, as multiple factors influence decision-making for adjuvant systemic therapy.

Cited by 30 publications

References 76 publications

Correlation between invasive mammary carcinoma grade and size in ultrasound-guided core needle biopsy and subsequent surgical excision

Correlation between invasive mammary carcinoma grade and size in ultrasound-guided core needle biopsy and subsequent surgical excision

Imaging breast cancer using hyperpolarized carbon-13 MRI

Validation and update of a lymph node metastasis prediction model for breast cancer

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