Optimum number of core biopsies for accurate assessment of histological grade in breast cancer

McIlhenny, C; Doughty, Julie; George, W D; Mallon, Elizabeth

doi:10.1046/j.0007-1323.2001.01950.x

Cited by 18 publications

(15 citation statements)

References 3 publications

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“…This is supported by O'Leary et al (2004) who showed in a series of 113 patients that the number and size of biopsies did not influence the concordance between preoperative and postoperative histopathology reports. In contrast, a short report published by McIlhenny et al (2002) found that a single core biopsy was only 32% accurate in predicting the grade, whereas this rate rose to 74% for four core biopsies ( P =0.001). Predictive factors in HR+/HER2− group are important to decide adjuvant systemic treatment or neo-adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 79%

Histological grade concordance between diagnostic core biopsy and corresponding surgical specimen in HR-positive/HER2-negative breast carcinoma

et al. 2014

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Background:The identification and validation of suitable predictive and prognostic factors are a challenge to improve the treatment scheme selection. Discordances in histological grade can be established between core biopsy and surgical specimens. This is important in HR-positive/HER2-negative subgroup where histological grade identifies patients at high risk and is a strong determinant for treatment scheme.Methods:A total of 350 consecutive invasive breast carcinoma biopsies were assessed and compared with surgical specimens in Institut Curie, Paris, France. Clinical, radiological and pathological data were recorded.Results:Histological grade concordance rate in the HR+/HER2− group was 75%. A grade underestimation was mainly due to mitotic index misgrading (23%). Large tumours (P<0.05), premenopausal patients (P=0.005) and non-ultrasound-guided biopsies (P=0.04) were risk factors for misgrading. The highest discordance was found in tumours that required chemotherapy (39%, P<0.05), and it was related to an underestimation of histological grade on core biopsies (94%).Conclusions:Histological grade in HR+/HER2− group is important to identify patients with poor prognosis and start a systemic therapy. Histological grade discordance was correlated with an underestimation of mitotic index and factors probably associated with intratumor heterogeneity (premenopausal status, tumour size and the type of core biopsy performed). But such discordance did not appear to modify the therapeutic decision, because systemic treatment decision-making also integrates other variables. Determining histological grade in core biopsy can be especially important in HR-positive/HER2-negative subgroup where it identifies patients at high risk and is a strong determinant of the treatment scheme.

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Section: Discussionmentioning

confidence: 79%

Histological grade concordance between diagnostic core biopsy and corresponding surgical specimen in HR-positive/HER2-negative breast carcinoma

et al. 2014

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“…Tumor type and histological grade have been included among the most important prognostic indicators of breast cancer, along with tumor size and axillary and distant metastases [7,10,11,12,13,16,23,25,26,29,34,35]. However, there are few studies assessing classical prognostic factors in CNB, such as histological classification and grade [1,5,17,24,31]. In this study, we tested the CNB accuracy of typing and grading breast carcinomas compared with the subsequent excisional specimens.…”

Section: Introductionmentioning

confidence: 95%

Accuracy of typing and grading invasive mammary carcinomas on core needle biopsy compared with the excisional specimen

Andrade

Gobbi

2004

Virchows Arch

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“…7 If neoadjuvant therapy is planned, then the full range of prognostic and predictive information must be provided from the CNB. This will include histological type, histological grade and the presence of lymphovascular invasion, if definitely identified.…”

Section: Cnb Reporting Of Invasive Carcinomamentioning

confidence: 99%

Breast core needle biopsy: issues and controversies

Bilous

2010

Modern Pathology

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Core needle biopsy (CNB) is increasingly being used in the investigation of breast disease whether this is asymptomatic and suspected after screening mammography, or presents symptomatically in the patient. In most cases, the result of the procedure provides a definitive diagnosis or at least provides information that is used to plan the further management of the patient. There are, however, a number of unresolved issues with the use of CNB; for example, with regard to the amount of information that can be reliably derived from CNB or with regard to the management of the patient after some CNB diagnoses. Oestrogen and progesterone receptors and HER2 are reported on both core biopsies and excision specimens, but there continues to be debate over which represents the more appropriate specimen type on which to perform these tests. There are a number of possible diagnoses after CNB for which the management is not straightforward and around which there may be controversy, or just a lack of sufficient evidence to support a definite management plan. These 'lesions of uncertain malignant potential' include papillary lesions, fibroepithelial lesions with cellular stroma, mucocoelelike lesions and radial scars. Currently, these are removed surgically but there may be an argument for more conservative management including vacuum-assisted core excision in some cases.

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Optimum number of core biopsies for accurate assessment of histological grade in breast cancer

Cited by 18 publications

References 3 publications

Histological grade concordance between diagnostic core biopsy and corresponding surgical specimen in HR-positive/HER2-negative breast carcinoma

Histological grade concordance between diagnostic core biopsy and corresponding surgical specimen in HR-positive/HER2-negative breast carcinoma

Accuracy of typing and grading invasive mammary carcinomas on core needle biopsy compared with the excisional specimen

Breast core needle biopsy: issues and controversies

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