TY - JOUR
T1 - A comparative analysis of core needle biopsy and final excision for breast cancer
T2 - Histology and marker expression
AU - Ough, Matthew
AU - Velasco, Jose
AU - Hieken, Tina J.
PY - 2011/5
Y1 - 2011/5
N2 - Background: Core needle biopsy (CNB) is used increasingly not only to diagnose breast cancer, but to determine tumor histology, grade and marker expression, select neoadjuvant therapy, and predict sentinel lymph node status. Thus, we undertook this study to evaluate the accuracy of CNB as a predictor of breast cancer histology and marker expression. Methods: We identified 209 Breast Cancer Registry cases with a preoperative CNB and reviewed all clinicopathologic data for accuracy. Statistical analysis was performed with statistical software. Results: CNB unequivocally showed cancer in 93%. Exact tumor histology concordance was 86%. Ductal carcinoma in situ on CNB was upgraded to invasive cancer in 23%. Concordance was substantial for estrogen receptor expression (88%, κ = .71), but kappa values were less than .6 for tumor grade, mitotic rate, progesterone receptor (PR), Ki-67, HER-2/neu, and p53 expression. Conclusions: Reliance on CNB grade and marker expression for critical decision making may be inadvisable. Further study is warranted to optimize breast cancer patient care.
AB - Background: Core needle biopsy (CNB) is used increasingly not only to diagnose breast cancer, but to determine tumor histology, grade and marker expression, select neoadjuvant therapy, and predict sentinel lymph node status. Thus, we undertook this study to evaluate the accuracy of CNB as a predictor of breast cancer histology and marker expression. Methods: We identified 209 Breast Cancer Registry cases with a preoperative CNB and reviewed all clinicopathologic data for accuracy. Statistical analysis was performed with statistical software. Results: CNB unequivocally showed cancer in 93%. Exact tumor histology concordance was 86%. Ductal carcinoma in situ on CNB was upgraded to invasive cancer in 23%. Concordance was substantial for estrogen receptor expression (88%, κ = .71), but kappa values were less than .6 for tumor grade, mitotic rate, progesterone receptor (PR), Ki-67, HER-2/neu, and p53 expression. Conclusions: Reliance on CNB grade and marker expression for critical decision making may be inadvisable. Further study is warranted to optimize breast cancer patient care.
KW - Breast cancer
KW - Core needle biopsy
KW - Her-2/neu
KW - Histology
KW - Tumor markers
KW - p53
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U2 - 10.1016/j.amjsurg.2010.02.015
DO - 10.1016/j.amjsurg.2010.02.015
M3 - Article
C2 - 20850706
AN - SCOPUS:79955679337
SN - 0002-9610
VL - 201
SP - 692
EP - 694
JO - American journal of surgery
JF - American journal of surgery
IS - 5
ER -