Validity of needle core biopsy in the histological characterisation of mammary lesions

Cipolla, Calogero; Fricano, Salvatore; Vieni, Salvatore; Amato, C; Napoli, Liborio; Graceffa, Giuseppa; Latteri, S; Latteri, M

doi:10.1016/j.breast.2005.01.007

Cited by 17 publications

(9 citation statements)

References 18 publications

(25 reference statements)

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“…Both core biopsy and VABB present results in agreement with the surgery in most cases, being considered to be the best tools in the diagnosis of breast lesions ( 15 - 18 , 21 ) . Additionally, they allow for planning the treatment in a single surgical time, including the axillary approach, avoiding unnecessary surgeries in up to 60% of cases and a second surgical time in 70% of cases ( 15 , 18 , 21 , 22 ) .…”

Section: Discussionsupporting

confidence: 74%

Diagnostic underestimation of atypical ductal hyperplasia and ductal carcinoma in situ at percutaneous core needle and vacuum-assisted biopsies of the breast in a Brazilian reference institution

Badan

Júnior

Piato³

et al. 2016

Radiol Bras

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ObjectiveTo determine the rates of diagnostic underestimation at stereotactic percutaneous core needle biopsies (CNB) and vacuum-assisted biopsies (VABB) of nonpalpable breast lesions, with histopathological results of atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS) subsequently submitted to surgical excision. As a secondary objective, the frequency of ADH and DCIS was determined for the cases submitted to biopsy.Materials and MethodsRetrospective review of 40 cases with diagnosis of ADH or DCIS on the basis of biopsies performed between February 2011 and July 2013, subsequently submitted to surgery, whose histopathological reports were available in the internal information system. Biopsy results were compared with those observed at surgery and the underestimation rate was calculated by means of specific mathematical equations.ResultsThe underestimation rate at CNB was 50% for ADH and 28.57% for DCIS, and at VABB it was 25% for ADH and 14.28% for DCIS. ADH represented 10.25% of all cases undergoing biopsy, whereas DCIS accounted for 23.91%.ConclusionThe diagnostic underestimation rate at CNB is two times the rate at VABB. Certainty that the target has been achieved is not the sole determining factor for a reliable diagnosis. Removal of more than 50% of the target lesion should further reduce the risk of underestimation.

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Section: Discussionsupporting

confidence: 74%

Diagnostic underestimation of atypical ductal hyperplasia and ductal carcinoma in situ at percutaneous core needle and vacuum-assisted biopsies of the breast in a Brazilian reference institution

Badan

Júnior

Piato³

et al. 2016

Radiol Bras

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“…The role of core needle biopsy has been clearly established as an important diagnostic tool for breast lesions, and it is considered the standard diagnostic method for breast disease (Di Loreto et al , 1996; Pettine et al , 1996; Pinder et al , 1996; Pijnappel et al , 1997; Crowe et al , 2003; Cipolla et al , 2006). The accuracy of core biopsy for the diagnosis of breast carcinoma is superior to the cytological diagnosis by fine needle aspiration, and a good concordance rate has been reported between core biopsy and surgical biopsy (91–100%), with a specificity rate ranging from 96% to 100% (Verkooijen et al , 2000).…”

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confidence: 99%

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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“…The histological features of the different cancers were obtained from a preoperative core biopsy performed on breast lesions. In all cases, core biopsy provided information that was fully confirmed by histopathological examination performed on a surgical specimen, establishing itself as a reliable tool for preoperative characterization of breast cancers [13,14]. 157 tumors (89.7%) were ductal type, while only 18 (10.3%) were classified as lobular.…”

Section: Patient Characteristicsmentioning

confidence: 86%

Application of a predictive model of axillary lymph node status in patients with sentinel node metastasis from breast cancer. A retrospective cohort study

Vieni

Graceffa

Mendola

et al. 2016

International Journal of Surgery

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h i g h l i g h t sIn about 60% of patients with metatstic SLN, there is no further axillary neoplastic involvement. MSKCC nomogram is a valid tool available to select the patients for axillary lymphadenectomy. The nomogram has a high reliability and a remarkable utility in clinical practice. a r t i c l e i n f o b s t r a c tBackground and objectives: The Axillary Lymph Node Dissection (ALND) is the standard treatment in patients with invasive breast cancer and sentinel node metastasis, but in 60% of the cases there is no further axillary neoplastic involvement, so this invasive intervention represents an overtreatment. The purpose of the study is to identify patients with low risk of additional nodal metastases, to omit ALND. Methods: The MSKCC Additional nodal metastasis nomogram was applied on a sample of 175 patients with invasive breast cancer who underwent ALND after detection of macrometastasis with the extemporaneous examination of the sentinel lymph node. Patients were classified as "low risk" when the result of the nomogram was 50%. Sensitivity, specificity, positive and negative predictive values and AUC (Area Under Curve) of the ROC curve of the nomogram were then calculated. Results: A cut-off by 50% yielded 92.3% sensitivity, 81,4% specificity, 80% positive predictive value and 92.9% negative predictive value. The ROC curve AUC in these patients was 0.885. Conclusions: The MSKCC nomogram has proven to be an effective tool in estimating the axillary lymph node status and it can potentially be used to better select the patients with sentinel node macrometastasis who can actually benefit from ALND.

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Validity of needle core biopsy in the histological characterisation of mammary lesions

Cited by 17 publications

References 18 publications

Diagnostic underestimation of atypical ductal hyperplasia and ductal carcinoma in situ at percutaneous core needle and vacuum-assisted biopsies of the breast in a Brazilian reference institution

Diagnostic underestimation of atypical ductal hyperplasia and ductal carcinoma in situ at percutaneous core needle and vacuum-assisted biopsies of the breast in a Brazilian reference institution

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

Application of a predictive model of axillary lymph node status in patients with sentinel node metastasis from breast cancer. A retrospective cohort study

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