Ryuji Ohashi1, Miyuki Matsubara2, Yasuhiko Watarai2, Keiko Yanagihara3, Koji Yamashita3, Shin-Ichi Tsuchiya2,4, Hiroyuki Takei3, Zenya Naito2,5. 1. Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. r-ohashi@nms.ac.jp. 2. Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. 3. Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan. 4. Department of Diagnostic Pathology, Iida Hospital, Nagano, Japan. 5. Department of Pathology and Integrative Oncological Pathology, Nippon Medical School, Tokyo, Japan.
Abstract
BACKGROUND: Although fine needle aspiration (FNA) biopsy is an established tool to assess breast lesions, there has been a trend toward using core needle biopsy (CNB) instead. The aim of this study was to compare the diagnostic accuracy of FNA and CNB in special types of breast cancer. METHODS: A retrospective review of diagnostic results of pre-operatively performed FNA or CNB, or a combination of the two, was conducted. The cases include histologically proven invasive ductal carcinoma of no special type (NST n = 159), invasive lobular carcinoma (ILC n = 65), mucinous carcinoma (MUC n = 51), and apocrine carcinoma (APO n = 25). RESULTS: The absolute diagnostic sensitivity of FNA to detect malignancy in ILC and APO patients was inferior to that of NST patients (p < 0.001 for ILC and APO). Within each cancer type, the sensitivity of CNB was higher than that of FNA in the ILC and APO patients (p < 0.001 and p < 0.05, respectively). As for NST and MUC patients, FNA and CNB had equivalent sensitivity. The sensitivity of FNA alone significantly improved when combined with CNB in NST, ILC and APO patients (p < 0.05, p < 0.001, and p < 0.05, respectively). CONCLUSIONS: Our results suggest that FNA has less diagnostic accuracy than CNB for ILC and APO; thus, the use of CNB should be encouraged when these types of cancer are clinically suspected or when the initial FNA is inconclusive.
BACKGROUND: Although fine needle aspiration (FNA) biopsy is an established tool to assess breast lesions, there has been a trend toward using core needle biopsy (CNB) instead. The aim of this study was to compare the diagnostic accuracy of FNA and CNB in special types of breast cancer. METHODS: A retrospective review of diagnostic results of pre-operatively performed FNA or CNB, or a combination of the two, was conducted. The cases include histologically proven invasive ductal carcinoma of no special type (NST n = 159), invasive lobular carcinoma (ILC n = 65), mucinous carcinoma (MUC n = 51), and apocrine carcinoma (APO n = 25). RESULTS: The absolute diagnostic sensitivity of FNA to detect malignancy in ILC and APOpatients was inferior to that of NST patients (p < 0.001 for ILC and APO). Within each cancer type, the sensitivity of CNB was higher than that of FNA in the ILC and APOpatients (p < 0.001 and p < 0.05, respectively). As for NST and MUC patients, FNA and CNB had equivalent sensitivity. The sensitivity of FNA alone significantly improved when combined with CNB in NST, ILC and APOpatients (p < 0.05, p < 0.001, and p < 0.05, respectively). CONCLUSIONS: Our results suggest that FNA has less diagnostic accuracy than CNB for ILC and APO; thus, the use of CNB should be encouraged when these types of cancer are clinically suspected or when the initial FNA is inconclusive.
Entities:
Keywords:
Core needle biopsy; Fine needle aspiration; Special type of cancer
Authors: Abdulkhaleq A Binnuhaid; Sultan Abdulwadoud Alshoabi; Fahad H Alhazmi; Tareef S Daqqaq; Suliman G Salih; Sami A Al-Dubai Journal: J Family Med Prim Care Date: 2019-12-10