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Use of Core Needle Biopsy rather than Fine-Needle Aspiration Cytology in the Diagnostic Approach of Breast Cancer.

Pagni P, Spunticchia F, Barberi S, Caprio G, Paglicci C - Case Rep Oncol (2014)

Bottom Line: The results demonstrated that among the 712 breast biopsies, in many cases FNAC was not conclusive, and therefore we proceeded with the echo-guided biopsy, through which we were able to collect sufficient material for the histological examination in order to direct patients to surgery or follow-up.CNB is far superior to FNAC, especially in cases of uncertainty, where it is preferable to proceed directly with CNB, which may also determine additional prognostic and predictive markers.Initially FNAC is less expensive, but the actual costs involved tend to be higher for FNAC as it is less accurate and a CNB is often required.

View Article: PubMed Central - PubMed

Affiliation: DAI Ematologia, Oncologia, Anatomia Patologica e Medicina Territoriale, University of Rome 'La Sapienza', Rome, Italy.

ABSTRACT

Background and aims: In the following study case, we reviewed breast ultrasound-guided core needle biopsy (CNB), using Mammotome (vacuum-assisted breast biopsy) and Tru-cut, carried out on palpable and nonpalpable uncertain breast lumps or malignant large lesions to be submitted to neoadjuvant chemotherapy.

Material and methods: Examinations were conducted during a 4-year period of clinical activity in a highly specialized center, from December 2009 to December 2013, in 712 patients previously subjected to fine-needle aspiration cytology (FNAC).

Results: The results demonstrated that among the 712 breast biopsies, in many cases FNAC was not conclusive, and therefore we proceeded with the echo-guided biopsy, through which we were able to collect sufficient material for the histological examination in order to direct patients to surgery or follow-up.

Conclusions: CNB is far superior to FNAC, especially in cases of uncertainty, where it is preferable to proceed directly with CNB, which may also determine additional prognostic and predictive markers. Initially FNAC is less expensive, but the actual costs involved tend to be higher for FNAC as it is less accurate and a CNB is often required. In accordance with recent publications, we can confirm the full validity of CNB in the diagnostic approach of breast lesions.

No MeSH data available.


Related in: MedlinePlus

All cases with positive histology and the correlation with ultrasound. Out of the 11% of the nodules classified as uncertain on ultrasound (U3), 10% were found to be malignant on histological examination. Only in 1% of cases, the CNB was not able to resolve the uncertainty, and patients were sent to surgery. 89% of those suspected positive on ultrasound (U4–5) were confirmed at histological examination.
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Figure 3: All cases with positive histology and the correlation with ultrasound. Out of the 11% of the nodules classified as uncertain on ultrasound (U3), 10% were found to be malignant on histological examination. Only in 1% of cases, the CNB was not able to resolve the uncertainty, and patients were sent to surgery. 89% of those suspected positive on ultrasound (U4–5) were confirmed at histological examination.

Mentions: In figures 1, 2 and 3, all positive biopsies were compared with mammography, ultrasound and cytology to assess which method was more reliable in the diagnosis of a malignant disease. Figure 1 shows that in 63% of patients with a diagnosis of mammographic R5, the diagnosis was confirmed by biopsy, in 7% of patients, the breast was too dense to highlight the lesion (R1), and in 31%, mammography detected uncertain lesions with benign prevalence (R3) to be later confirmed after histological sampling [21]. 35% of the lumps that were non-diagnostic or benign at cytological examination (C1, C2) had a positive biopsy, 16% of C3 were neoplastic lesions, in 49% of cases in which cytology identified the nodule as suspicious or a certainty for malignancy (C4, C5), the diagnosis was confirmed by biopsy (fig. 2). Figure 3 shows all the cases with positive histology and the correlation with ultrasound. Among the 11% of the nodules classified as uncertain on ultrasound (U3), 10% were found to be malignant on histological examination. Only in 1% of the cases was the CNB unable to resolve the uncertainty, and the patients were sent to surgery; 89% of those suspected positive to ultrasound (U4–U5) were confirmed at histological examination.


Use of Core Needle Biopsy rather than Fine-Needle Aspiration Cytology in the Diagnostic Approach of Breast Cancer.

Pagni P, Spunticchia F, Barberi S, Caprio G, Paglicci C - Case Rep Oncol (2014)

All cases with positive histology and the correlation with ultrasound. Out of the 11% of the nodules classified as uncertain on ultrasound (U3), 10% were found to be malignant on histological examination. Only in 1% of cases, the CNB was not able to resolve the uncertainty, and patients were sent to surgery. 89% of those suspected positive on ultrasound (U4–5) were confirmed at histological examination.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127550&req=5

Figure 3: All cases with positive histology and the correlation with ultrasound. Out of the 11% of the nodules classified as uncertain on ultrasound (U3), 10% were found to be malignant on histological examination. Only in 1% of cases, the CNB was not able to resolve the uncertainty, and patients were sent to surgery. 89% of those suspected positive on ultrasound (U4–5) were confirmed at histological examination.
Mentions: In figures 1, 2 and 3, all positive biopsies were compared with mammography, ultrasound and cytology to assess which method was more reliable in the diagnosis of a malignant disease. Figure 1 shows that in 63% of patients with a diagnosis of mammographic R5, the diagnosis was confirmed by biopsy, in 7% of patients, the breast was too dense to highlight the lesion (R1), and in 31%, mammography detected uncertain lesions with benign prevalence (R3) to be later confirmed after histological sampling [21]. 35% of the lumps that were non-diagnostic or benign at cytological examination (C1, C2) had a positive biopsy, 16% of C3 were neoplastic lesions, in 49% of cases in which cytology identified the nodule as suspicious or a certainty for malignancy (C4, C5), the diagnosis was confirmed by biopsy (fig. 2). Figure 3 shows all the cases with positive histology and the correlation with ultrasound. Among the 11% of the nodules classified as uncertain on ultrasound (U3), 10% were found to be malignant on histological examination. Only in 1% of the cases was the CNB unable to resolve the uncertainty, and the patients were sent to surgery; 89% of those suspected positive to ultrasound (U4–U5) were confirmed at histological examination.

Bottom Line: The results demonstrated that among the 712 breast biopsies, in many cases FNAC was not conclusive, and therefore we proceeded with the echo-guided biopsy, through which we were able to collect sufficient material for the histological examination in order to direct patients to surgery or follow-up.CNB is far superior to FNAC, especially in cases of uncertainty, where it is preferable to proceed directly with CNB, which may also determine additional prognostic and predictive markers.Initially FNAC is less expensive, but the actual costs involved tend to be higher for FNAC as it is less accurate and a CNB is often required.

View Article: PubMed Central - PubMed

Affiliation: DAI Ematologia, Oncologia, Anatomia Patologica e Medicina Territoriale, University of Rome 'La Sapienza', Rome, Italy.

ABSTRACT

Background and aims: In the following study case, we reviewed breast ultrasound-guided core needle biopsy (CNB), using Mammotome (vacuum-assisted breast biopsy) and Tru-cut, carried out on palpable and nonpalpable uncertain breast lumps or malignant large lesions to be submitted to neoadjuvant chemotherapy.

Material and methods: Examinations were conducted during a 4-year period of clinical activity in a highly specialized center, from December 2009 to December 2013, in 712 patients previously subjected to fine-needle aspiration cytology (FNAC).

Results: The results demonstrated that among the 712 breast biopsies, in many cases FNAC was not conclusive, and therefore we proceeded with the echo-guided biopsy, through which we were able to collect sufficient material for the histological examination in order to direct patients to surgery or follow-up.

Conclusions: CNB is far superior to FNAC, especially in cases of uncertainty, where it is preferable to proceed directly with CNB, which may also determine additional prognostic and predictive markers. Initially FNAC is less expensive, but the actual costs involved tend to be higher for FNAC as it is less accurate and a CNB is often required. In accordance with recent publications, we can confirm the full validity of CNB in the diagnostic approach of breast lesions.

No MeSH data available.


Related in: MedlinePlus