The accuracy of frozen section analysis in ultrasound- guided core needle biopsy of breast lesions

Abstract

BackgroundLimited data are available to evaluate the accuracy of frozen section analysis and ultrasound- guided core needle biopsy of the breast.MethodsIn a retrospective analysis data of 120 consecutive handheldultrasound- guided 14- gauge automated core needle biopsies (CNB) in 109 consecutive patients with breast lesions between 2006 and 2007 were evaluated.ResultsIn our outpatient clinic120 CNB were performed. In 59/120 (49.2%) cases we compared histological diagnosis on frozen sections with those on paraffin sections of CNB and finally with the result of open biopsy. Of the cases 42/59 (71.2%) were proved to be malignant and 17/59 (28.8%) to be benign in the definitive histology. 2/59 (3.3%) biopsies had a false negative frozen section result. No false positive results of the intraoperative frozen section analysis were obtained, resulting in a sensitivity, specificity and positive predicting value (PPV) and negative predicting value (NPV) of 95%, 100%, 100% and 90%, respectively. Histological and morphobiological parameters did not show up relevance for correct frozen section analysis. In cases of malignancy time between diagnosis and definitive treatment could not be reduced due to frozen section analysis.ConclusionThe frozen section analysis of suspect breast lesions performed by CNB displays good sensitivity/specificity characteristics. Immediate investigations of CNB is an accurate diagnostic tool and an important step in reducing psychological strain by minimizing the period of uncertainty in patients with breast tumor.

Percutaneous core biopsy of palpable breast lesions: accuracy of frozen section histopathological exam in the diagnosis of breast cancer

“…In another prospective cohort study, with a sample of 120 CNBs of palpable and impalpable tumors suspicious of breast cancer, the authors compared the frozen section technique with paraffin and suggested that frozen section showed good accuracy and enabled earlier diagnosis of breast cancer. The results were: sensitivity 95%, specificity 100%, PPV 100% and NPV 90% 24 .…”

Elastography ultrasound for breast lesions: fat-to-lesion strain ratio vs gland-to-lesion strain ratio

“…Core needle biopsy (CNB) and fine needle aspiration cytology (FNA) are well-established methods for characterizing breast lesions [28][29][30][31]; however, both methods are invasive and relatively expensive. In addition to mammography, US has become a standard non-invasive diagnostic imaging method used for the detection of breast cancer, particularly in the dense breast [32][33][34].…”

Role of short-term follow-up magnetic resonance imaging in the detection of post-operative residual breast cancer

“…With the development of cytological techniques for determining the nature of sono-or mammographically diagnosed breast abnormalities, percutaneous image-guided core needle biopsy has become an alternative to surgical biopsy for the histological assessment of breast lesions (13). However, intraoperative frozen section pathology is widely used in numerous countries, including China.…”