Value of combined use of fine‐needle aspiration and core needle biopsy in palpable breast tumors performed by pathologist: Institut Curie experience

Sustova, Pavla; Klijanienko, Jerzy

doi:10.1002/dc.24311

Cited by 12 publications

(15 citation statements)

References 31 publications

(46 reference statements)

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“…The 3×2 cell matrix summarizes all the data observed including suspect results, giving more characteristics to the diagnostic test such as Y + , Y − and LR ±. Note that the S e c and S p e c obtained when we only handled the suspect results, applying the conditional 3×2 cell matrix proposed by Simel et al [ 16 ], were close to those obtained by Sustova et al [ 4 ]. However, verification bias had to be handled too.…”

Section: Discussionsupporting

confidence: 74%

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Statistical methods for evaluating the fine needle aspiration cytology procedure in breast cancer diagnosis

Chamieh

Vielh

Chevret

2022

BMC Med Res Methodol

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Background Statistical issues present while evaluating a diagnostic procedure for breast cancer are non rare but often ignored, leading to biased results. We aimed to evaluate the diagnostic accuracy of the fine needle aspiration cytology(FNAC), a minimally invasive and rapid technique potentially used as a rule-in or rule-out test, handling its statistical issues: suspect test results and verification bias. Methods We applied different statistical methods to handle suspect results by defining conditional estimates. When considering a partial verification bias, Begg and Greenes method and multivariate imputation by chained equations were applied, however, and a Bayesian approach with respect to each gold standard was used when considering a differential verification bias. At last, we extended the Begg and Greenes method to be applied conditionally on the suspect results. Results The specificity of the FNAC test above 94%, was always higher than its sensitivity regardless of the proposed method. All positive likelihood ratios were higher than 10, with variations among methods. The positive and negative yields were high, defining precise discriminating properties of the test. Conclusion The FNAC test is more likely to be used as a rule-in test for diagnosing breast cancer. Our results contributed in advancing our knowledge regarding the performance of FNAC test and the methods to be applied for its evaluation.

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Section: Discussionsupporting

confidence: 74%

“…When diagnosing breast tumors, the Fine Needle Aspiration Cytology (FNAC) test is widely used [ 4 ]. It has been reported as a simple, minimally invasive, and cost-effective technique for the diagnosis of breast cancer [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Statistical methods for evaluating the fine needle aspiration cytology procedure in breast cancer diagnosis

Chamieh

Vielh

Chevret

2022

BMC Med Res Methodol

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“…Therefore, we continue to recommend FNAB for the evaluation of breast masses, especially in a low-risk setting like BIRADS 4a tumors. Other studies have found comparable performance for FNAB compared to CNB in palpable breast tumors [19].…”

Section: Discussionmentioning

confidence: 94%

Accuracy of Breast Fine-Needle Aspiration Biopsy Using the International Academy of Cytology Yokohama System in Clinico-Radiologically Indeterminate Lesions: Initial Findings Demonstrating Value in Lesions of Low Suspicion of Malignancy

et al. 2021

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Background: Fine-needle aspiration biopsy (FNAB) in breast lesions offers accurate results in differentiating benign and malignant lesions. However, its role is unclear when core-needle biopsy (CNB) is available, the latter providing additional information regarding tumor grade, invasion, and hormone receptor status in malignant lesions. In benign breast lesions, especially in BIRADS category 4a and 4b, FNAB, and CNB provide similar pathological information, whereby FNAB may serve as a more rapid and cost-effective investigation. The study was planned to reevaluate the diagnostic accuracy of FNAB in BIRADS category 4a, 4b, and 4c lesions. Materials and Methods: FNAB and biopsy reports of all patients with breast lesions sent between September 1, 2018, and November 30, 2020, were collected and the International Academy of Cytology (IAC) Yokohama category and BIRADS score were recorded for each case. The rate of malignancy and the accuracy of FNAB in diagnosing malignancy were calculated for each BIRADS 4a, 4b, and 4c subgroup. Results: A total of 249 cases of BIRADS 4 lesions had corresponding cytology and histopathology diagnoses. FNAB showed high diagnostic accuracy in all BIRADS groups. A benign categorization was associated with a very low number of false-negative diagnoses, especially in BIRADS 4a lesions. Conclusion: The study reconfirms the excellent accuracy of breast FNAB using the IAC Yokohama system in diagnosing breast malignancies. Furthermore, BIRADS 4a lesions found to be belonging to the cytological benign category may be excluded from CRB and kept on clinical follow-up.

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“…Even though core‐needle biopsies are recommended for a confirmatory diagnosis of breast cancer, 15 we believe that FNAB still should play an important role in the diagnosis of breast lesions 16 . Core‐needle biopsies provide the ability to document invasion and conveniently provide tissue for assessment of estrogen receptor, Progesterone receptor, and HER2 positivity in the invasive component in malignant lesions, 17 but FNAB provides a few advantages when assessing benign lesions.…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of accuracy of fine‐needle aspiration biopsy for breast lesions using the International Academy of Cytology Yokohama System for reporting breast cytopathology

Agrawal

Anthony

Paul

et al. 2021

Diagnostic Cytopathology

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Background Classification of breast lesions into different cytological groups can accurately be done using the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology. Fine needle aspiration biopsy (FNAB) of breast lesions has been considered to be the primary investigation in detecting breast cancers, especially in low‐cost settings. The main objective of this study was to prospectively re‐confirm the diagnostic accuracy of breast FNAB using the IAC Yokohama system. Additionally, separate secondary subgroup analysis was done to confirm the accuracy of breast FNAB excluding lymph‐node positive and lymphadenopathy positive tumors. Material and methods A prospective study was done on patients undergoing biopsy of breast lesions between September 01, 2019 and November 30, 2020 (519 biopsies on 487 unique patients). Of these 519 histopathology biopsies, 505 had corresponding FNAB report of the same site. The FNAB was reported using the IAC Yokohama system and the most suitable category was allotted in every case. The rates of malignancy for each category and the accuracy of breast FNAB in diagnosing malignancy were calculated. Results Of the total 487 patients, 120 cases were benign on histology, while 367 were malignant. The rates of malignancy in benign, atypical, suspicious and malignant categories were 5%, 25%, 71%, and 99.7%, respectively. The diagnostic accuracy of atypical, suspicious and malignant categories was calculated as 90.1%, 95.2%, and 93.3%, respectively. Conclusion The high diagnostic accuracy for each BIRADS category suggest excellent accuracy for Breast FNAB using the IAC Yokohama system.

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Value of combined use of fine‐needle aspiration and core needle biopsy in palpable breast tumors performed by pathologist: Institut Curie experience

Cited by 12 publications

References 31 publications

Statistical methods for evaluating the fine needle aspiration cytology procedure in breast cancer diagnosis

Statistical methods for evaluating the fine needle aspiration cytology procedure in breast cancer diagnosis

Accuracy of Breast Fine-Needle Aspiration Biopsy Using the International Academy of Cytology Yokohama System in Clinico-Radiologically Indeterminate Lesions: Initial Findings Demonstrating Value in Lesions of Low Suspicion of Malignancy

Prospective evaluation of accuracy of fine‐needle aspiration biopsy for breast lesions using the International Academy of Cytology Yokohama System for reporting breast cytopathology

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