Fine-Needle Aspiration Cytology versus Core-Needle Biopsy for Breast Lesions: A Dilemma of Superiority between the Two

Verma, Priyanka; Sharma, Ravi; Sharma, Neelam; Gulati, Anchana; Parashar, Anupam; Kaundal, Ashok

doi:10.1159/000517005

Cited by 5 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…FNAC is cost-effective, minimally invasive and can be performed in the clinic setting. 14,28 Ancillary testing which could improve the diagnostic accuracy of FNAC is critical to a public health screening program.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, pre-analytical delays can influence the performance of adjunctive testing modalities like IHC and FISH. FNAC is cost-effective, minimally invasive and can be performed in the clinic setting 14,28 . Ancillary testing which could improve the diagnostic accuracy of FNAC is critical to a public health screening program.…”

Section: Discussionmentioning

confidence: 99%

“…Fine needle aspiration cytology (FNAC) represents a cost-effective alternative in low-resource settings, provides a faster turnaround time, and has acceptable accuracy for determining presence of cancer cells, although it may not accurately differentiate "gray-zone" lesions (containing atypical cells that may be malignant or benign tumors) including noninvasive lesions like ductal carcinoma in situ which would not warrant aggressive management. 13,14 In these cases, the need for a formal biopsy should be considered. This notwithstanding, FNAC is included in the South African breast cancer screening program.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Validation of the Xpert Breast Cancer STRAT 4 Assay on the GeneXpert instrument to Assess Hormone Receptor, Ki67, and HER2 Gene Expression Status in Breast Cancer Tissue Samples

Sewanywa,

Hale,

Michelow

et al. 2023

Applied Immunohistochemistry &Amp; Molecular Morphology

View full text Add to dashboard Cite

Breast cancer is the commonest cause of cancer-related mortality in African females where patients often present later and with advanced disease. Causes for delayed diagnosis include restricted diagnostic access and international controversy on interpretation of ancillary tests like immunohistochemistry (IHC). Fine needle aspirates (FNAC) are an attractive alternative although may have reduced sensitivity. The Xpert Breast Cancer STRAT4 (STRAT4) (CE-IVD*) assay (Cepheid, Sunnyvale) is a semi-quantitative reverse-transcription polymerase chain reaction assay which detects messenger RNA (mRNA) expression in breast samples for estrogen receptor (ESR1), progesterone receptor (PGR1), human epidermal growth factor receptor/Erb-B2 receptor tyrosine kinase 2 (HER2/ERBB2) and the proliferation marker, MKi67. We assessed the performance of this assay on both formalin-fixed paraffin-embedded (FFPE, n=31) and matched FNAC (n=20) samples from patients presenting with breast cancer to the Johannesburg academic hospitals. IHC and Fluorescent in situ hybridization analysis (performed on HER2-indeterminate samples) was compared with the mRNA expression of the corresponding target genes in FFPE samples, and mRNA expression on FNAC samples was compared with the FFPE results for both mRNA expression and IHC. Concordance between IHC/FISH and Xpert Breast Cancer STRAT4 in FFPE and FNAC samples using the Quick lysis (Q) method (a research-use-only modification of the validated FFPE-lysis method), showed an overall percentage agreement for ESR1 expression of 90.3% and 81.3%, and for PGR1 expression at 86.7% and 81.3% respectively in FFPE and FNAC samples. Concordance was lowest for Ki67 expression, using a binary IHC cutoff for Ki67 positivity at ≥20% staining) at 83.9% and 62.5%, for FFPE and FNAC samples, respectively. This suggests that the STRAT4 assay may be a useful ancillary test in determining HR and Ki67 status in FFPE samples and that use on FNAC samples may be feasible. Future studies should expand the sample numbers and establish locally relevant cutoffs.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Validation of the Xpert Breast Cancer STRAT 4 Assay on the GeneXpert instrument to Assess Hormone Receptor, Ki67, and HER2 Gene Expression Status in Breast Cancer Tissue Samples

Sewanywa,

Hale,

Michelow

et al. 2023

Applied Immunohistochemistry &Amp; Molecular Morphology

View full text Add to dashboard Cite

show abstract

“…In our sample, CNB was performed on older patients, while FNA and submission for cytology were performed on younger patients. This may be explained by clinicians having a higher clinical suspicion of breast carcinoma in older patients [17].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of the Clinicopathological Features of Patients with Tuberculous Mastitis: A Single Institution’s Experience

Olmesdahl,

Nel,

Mannell

et al. 2023

Acta Cytologica

View full text Add to dashboard Cite

Background: Tuberculosis remains a global health burden, especially in low- and middle-income countries. Breast tuberculosis is a rare disease with minimal research available. This disease produces a diagnostic challenge as the clinical presentation is variable, and diagnosis often requires additional investigations. This study was undertaken to determine the efficacy of cytology and histology, together with ancillary studies, in diagnosing tuberculous mastitis. Methods: This retrospective study was conducted in a Johannesburg Hospital over five years. Thirty-two patients with confirmed tuberculous mastitis were included. The patients were considered positive for tuberculous mastitis if histological or cytological findings were confirmed with either a positive tuberculosis culture, Ziehl-Neelsen stain or polymerase chain reaction examination/GeneXpert. Results: This case series comprises 3 males and 29 females with a mean age of 35.66. A breast mass was the most common presentation. Over these five years, more biopsies were performed on inflammatory breast lesions than fine needle aspirations. There was a higher confirmation rate for cytology diagnoses compared to histology diagnoses. Conclusion: This study supports using fine needle aspiration combined with GeneXpert as the primary diagnostic modality in diagnosing tuberculous mastitis. This test combination is advantageous in resource and financially constrained environments as it is relatively simple to perform, cost-effective and has a rapid turnaround time.

show abstract

“…Compared to the present study, a much lower agreement between CNB and FNAC was reported by Tikku and Umap who found this agreement in 58/107 (54.2%) cases only [ 14 ]. Verma et al in their study assessed the agreement for different corresponding cytological and biopsy categories and found it to range from poor (C1) to near-perfect (C2) [ 20 ]. In another study, Siddavatan et al found a moderate concordance between FNAC and CNB, similar to the present study [ 16 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study Between Fine-Needle Aspiration Cytology and Core Needle Biopsy in Diagnosing Clinically Palpable Breast Lumps

Tripathi¹,

Yadav²,

Maurya³

2022

Cureus

View full text Add to dashboard Cite

Background and objectiveMost breast diseases present as palpable lumps. The accuracy of their diagnosis can be enhanced by a combination of clinical examination, mammography, fine-needle aspiration cytology (FNAC), and core needle biopsy (CNB) preoperatively. The ultimate aim of FNAC or CNB of the breast mass is to confirm the diagnosis of cancer preoperatively, which may help avoid unnecessary surgeries for benign conditions. Histopathology is the gold standard to establish the diagnosis of a breast mass. In this study, we aimed to compare the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of FNAC with those of trucut biopsy, and provide a combined assessment of FNAC and CNB against the final histopathological diagnosis of excised breast mass in suspected breast malignancies. Materials and methodsThis was a prospective, observational, cross-sectional study conducted for a duration of one year involving 42 patients with suspected breast cancer cases who underwent FNAC, CNB, and surgical excision followed by a histopathological examination. Data were collected and analyzed in terms of sensitivity, specificity, PPV, NPV, and diagnostic accuracy of FNAC and CNB in comparison with histopathology. ResultsThe majority of the patients in the study (78.6%) were in the age group of 31-50 years. In our study, FNAC showed a sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 74.1%, 76.9%, 87.0%, 64.7%, and 75% respectively. CNB had a sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 85.2%, 92.8%, 95.8%, 76.5%, and 87.8% respectively. The level of agreement between the two modalities (FNAC and CNB) was moderate and statistically significant (k=0.543; p<0.001). In the combined assessment of FNAC and CNB against final histopathological diagnosis for malignancy/borderline diagnosis, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 89.3%, 85.7%, 92.6%, 80%, and 88.1% respectively. ConclusionThe diagnostic accuracy of the combined assessment of FNAC and CNB against final histopathological diagnosis for malignancy/borderline diagnosis was better than that of FNAC or CNB alone. This finding shows that both the techniques complement each other. FNAC and CNB are used as the first-and secondline methods of pathological diagnosis respectively.

show abstract

Fine-Needle Aspiration Cytology versus Core-Needle Biopsy for Breast Lesions: A Dilemma of Superiority between the Two

Cited by 5 publications

References 16 publications

Validation of the Xpert Breast Cancer STRAT 4 Assay on the GeneXpert instrument to Assess Hormone Receptor, Ki67, and HER2 Gene Expression Status in Breast Cancer Tissue Samples

Validation of the Xpert Breast Cancer STRAT 4 Assay on the GeneXpert instrument to Assess Hormone Receptor, Ki67, and HER2 Gene Expression Status in Breast Cancer Tissue Samples

A Retrospective Analysis of the Clinicopathological Features of Patients with Tuberculous Mastitis: A Single Institution’s Experience

A Comparative Study Between Fine-Needle Aspiration Cytology and Core Needle Biopsy in Diagnosing Clinically Palpable Breast Lumps

Contact Info

Product

Resources

About