Core Biopsy as Alternative to Fine‐Needle Aspiration Biopsy in Diagnosis of Breast Tumors

Abstract

In spite of the widespread use of cytological smears for diagnosis of breast cancer lesions, many surgeons are still reluctant to accept the cytological report as the only criterion for performing definitive surgery. Modern surgical strategy requires a preoperative planning of the surgical treatment, possible through the use of core biopsy, which provides a diagnosis based on tissue specimens, thus permitting the study of both the architectural and cytological patterns. The authors report their five‐year experience with this technique and evaluate its diagnostic usefulness and ability to reduce intraoperative biopsy procedures. The histological examination of 92 palpable breast lesions, clinically and mammographically detected, was performed with core biopsy, and diagnosis was confirmed with the surgical sample in 80 cases. A definitive histological diagnosis was obtained with core biopsy in 90% of cases. Only nine cases required confirmation with frozen section diagnosis at the time of definitive surgery. The sensibility of core biopsy was 92%, specificity and predictive value of positive result were 100%, and diagnostic efficiency was 86%. This study confirms the usefulness of systematic use of core biopsy for definitive preoperative diagnosis of breast cancer; the simplicity, safety and low cost of this method also make ultrasound‐guided core biopsy applicable to nonpalpable lesions.

Fine Needle Aspiration Cytology Verses Trucut Biopsy In Preoperative Planning Of Surgical Treatment Of Breast Lumps

“…The sensitivity of core biopsy was 95.45%, specificity and predictive value of positive result were 100%. This study confirms that core biopsy should be routinely performed for preoperative diagnosis of breast lesions being a cost effective, safe and simple procedure to be performed in the office settings under local anaesthetics and without much preprocedure preparations [4]. FNAC to evaluate a breast lump shows a high sensitivity, specificity and accuracy [6,12,13,14,15] but trucut always provides a better histological diagnosis and is more accurate and more trusted.…”

“…Trucut needle biopsy is a good alternative. Also it is an alternative to open biopsy for neoplastic breast lesions [3,4]. Tissue samples should not be replaced by cytological material when core biopsies can be performed easily and without contraindications.…”

“…Tissue samples should not be replaced by cytological material when core biopsies can be performed easily and without contraindications. In fact trucut biopsy can substitute both FNAC and open biopsy [4].…”

“…Core biopsy supports a definitive diagnosis, permits to take an immediate decision regarding treatment in 90% of cases. In case of diagnostic discordance between mammography and trucut biopsy, an intra operative frozen section biopsy used for decision making [4]. In trucut biopsy complication rates are low, a scar is avoided and its cost effective.…”

Combined Use of Unguided FNA and CNB Increases the Diagnostic Accuracy for Palpable Breast Lesions

“…Moreover, FNA can also serve to confirm the diagnosis of metastatic neoplasms to the breast in suspected cases . However, the use of FNA is rapidly declining in favor of CNB even for palpable lesions . That's mainly due to the better distinction of CNB between low‐grade cancers versus non‐cancerous lesions such as atypical duct hyperplasia (ADH), and between in situ and invasive cancers.…”