Comparison of Stereotactic Fine Needle Aspiration Cytology and Core Needle Biopsy in 522 Non-Palpable Breast Lesions

Leifland, Karin; Lagerstedt, U.; Svane, Gunilla

doi:10.1034/j.1600-0455.2003.00098.x

Cited by 47 publications

(28 citation statements)

References 21 publications

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“…Direct comparison of the results of various FNAC studies may not be appropriate, as the defining conditions of various diagnostic categories, technical details, and other parameters may not be the same [3]. Results from studies comparing CNB and FNAC showed generally a higher sensitivity and specificity for CNB than FNAC, with a sensitivity and specificity for malignancy of more than 90% for CNB, whereas for FNAC, the corresponding figures had been reported to be lower than 70% [11], and in one series, a sensitivity of 34.5% and specificity of 47.6% were reported [13]. When only the definitive benign and malignant categories were considered (i.e., ignoring the atypical and suspicious categories), the performance indices of FNAC improved and reached above 95% [15].…”

Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 85%

“…This had been aptly illustrated in a study in which the inadequacy rate was higher in benign than malignant lesions upon final excision [12]. The inadequacy rate of CNB in non palpable lesions ranged from 0 to 20% [11,13,17]. Although this range appeared to be significantly lower than that for FNAC, one has to interpret this with caution.…”

Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 85%

“…However, it must be pointed out that in real life situations, the atypical and suspicious categories usually accounted for about 20% in most series. These figures notwithstanding, in studies where there was comparison between CNB and FNAC, all reported higher performance indices for CNB over FNAC [11][12][13]17]. In addition, CNB allowed a more accurate assessment of tumor grade in cases of cancer [17].…”

Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 89%

“…One of the ways to analyze whether the inadequacy rate was clinically relevant was to evaluate the negative predictive value (NPV) (confirmatory diagnosis of benign lesion). It has been reported that the inadequacy rate in FNAC was inversely related to NPV, whereas that for CNB did not, indicating that the inadequate CNB was truly benign, but not for FNAC [11]. How can one solve the inadequancy problem of FNAC?…”

Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 97%

“…In this setting, both CNB and FNAC are initial investigations of choice, and many studies have been done comparing these two modalities [11][12][13][14][15][16][17]. Direct comparison of the results of various FNAC studies may not be appropriate, as the defining conditions of various diagnostic categories, technical details, and other parameters may not be the same [3].…”

Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 99%

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Diagnosing breast lesions by fine needle aspiration cytology or core biopsy: which is better?

Tse

Tan

2010

Breast Cancer Res Treat

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Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) are widely used in diagnosing breast lesions, with both achieving high sensitivity and specificity. Whether FNAC or CNB is better remains highly controversial. In this review, the advantages and disadvantages of each of these methods are discussed, especially in relation to specific problematic groups of breast lesions. In general, CNB has a slight advantage with lower inadequate and suspicious rates, allowing easier grade assessment and ancillary testings (hormome receptors, HER2) in cases of cancers. FNAC cannot reliably predict invasion in a malignant aspirate, whereas CNB, although useful in confirming invasion in carcinomas, has a much lower efficacy in predicting invasion when only in situ carcinoma is detected. The other problematic areas are papillary breast lesions and fibroepithelial lesions, notably phyllodes tumors. In papillary lesions, FNAC diagnosis is inaccurate, but with CNB, one can confidently diagnose papillary lesion, although there is still significant false positive and false negative rates, even with immunohistochemistry. For fibroepithelial lesions, using either FNAC or CNB to differentiate between a phyllodes tumor from fibroadenoma is also inaccurate. As management of breast diseases necessitates the triple approach (clinical, imaging and pathological), an awareness of the limitations of these very useful diagnostic modalities by all specialists is prudent, especially when dealing with these specific groups of breast lesions.

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Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 85%

Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 85%

Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 89%

Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 97%

Section: Non Palpable Mammographic Detected Lesionsmentioning

confidence: 99%

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Diagnosing breast lesions by fine needle aspiration cytology or core biopsy: which is better?

Tse

Tan

2010

Breast Cancer Res Treat

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Stereotactic vacuum‐assisted breast biopsy in 2874 patients

Kettritz

Rotter

Schreer

et al. 2004

Cancer

218

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BACKGROUND Vacuum‐assisted breast biopsy (VAB) can replace surgical biopsy for the diagnosis of breast carcinoma. The authors evaluated the accuracy and clinical utility of VAB in a multicenter setting using a strict quality assurance protocol. METHODS In the current study, VABs were performed successfully for 2874 patients at 5 sites. Benign lesions were verified by follow‐up. Surgery was recommended for malignant and borderline lesions. VAB was performed on patients with lesions rated as highly suspicious (6%), intermediate to suspicious (85%), or probably benign (9%). Fifty‐eight percent of the lesions were < 10 mm and 70% had microcalcifications. RESULTS The authors identified 7% of patients with invasive carcinomas, 15% with ductal carcinomas in situ (DCIS), 5% with atypical ductal hyperplasias (ADH), and 0.6% with lobular carcinomas in situ. The results of the VAB necessitated an upgrade of 24% of patients with ADH to DCIS or DCIS and invasive carcinoma. Twelve percent of patients with DCIS proved to have invasive carcinoma. Seventy‐three percent of the patients had benign lesions. Only 1 false‐negative result was encountered (negative predictive value, 99.95%). Minor side effects were reported to occur in 1.4% of patients and 0.1% of patients required a subsequent intervention. Scarring relevant for mammography was rare among patients (i.e., 0.3% of patients had relevant scarring). CONCLUSIONS Quality‐assured VAB was found to be highly reliable. VAB effectively identified patients with benign lesions and assisted therapeutic decisions. Most important, only a single case of malignancy was missed. A close interdisciplinary approach assured optimal results. Cancer 2004;100:245–51. © 2003 American Cancer Society.

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Paired ductal lavage and fine-needle aspiration specimens from patients with breast carcinoma

et al. 2005

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Ductal lavage (DL) is a new procedure for sampling of the mammary epithelium, but experience with this technique remains limited. We compared the findings in paired DL and fine-needle aspiration (FNA) specimens obtained from patients with breast carcinoma. Four reviewers evaluated all DL samples. Two reviewers also examined the FNA material and compared cellular composition and morphologic findings in paired samples. DL and FNA samples from six patients were satisfactory for evaluation. Two DL samples showed marked atypia, one showed mild atypia, and two were benign; there was no agreement in one case (mild atypia vs. benign). Overall, the atypical cells in DL samples resembled those in the paired FNA material, but low degree of cytologic atypia and relative paucity of atypical cells limited their correct identification. The interpretation of DL samples is more challenging than that of FNA material, but similar criteria apply. To increase the sensitivity of DL, the number of epithelial cells required for a satisfactory sample should be higher than previously set.

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Comparison of Stereotactic Fine Needle Aspiration Cytology and Core Needle Biopsy in 522 Non-Palpable Breast Lesions

Abstract: S-CNB was more accurate than S-FNAC in the diagnosis of non-palpable breast cancer.

Cited by 47 publications

References 21 publications

Diagnosing breast lesions by fine needle aspiration cytology or core biopsy: which is better?

Diagnosing breast lesions by fine needle aspiration cytology or core biopsy: which is better?

Stereotactic vacuum‐assisted breast biopsy in 2874 patients

Paired ductal lavage and fine-needle aspiration specimens from patients with breast carcinoma

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