The diagnostic accuracy of core biopsy in palpable and non-palpable breast lesions

Pijnappel, Ruud M.; Dalen, A. Van; Rinkes, Inne H.M. Borel; Tweel, Jan G. van den; Mali, Willem P.Th.M.

doi:10.1016/s0720-048x(96)01140-0

Cited by 55 publications

(51 citation statements)

References 13 publications

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“…In the study of Pijnappel et al (1997), there was clinically relevant discrepancy in five of 76 cases (one ADH underestimate, three DCIS underestimates and one miss), resulting in a reclassified agreement rate of 93% (95% CI 85-98%). In the study of Jackman et al (1999) there were 26 discrepancies (16 ADH underestimates, eight DCIS underestimates and two misses) on a total of 483 lesions, resulting in a reclassified agreement rate of 95% (95% CI 92-97) in this study.…”

Section: Resultsmentioning

confidence: 95%

“…In four studies the percentage of lesions with microcalcifications was reported (Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997;Jackman et al, 1999) which varied from 21 to 48%. The malignancy rate varied from 23 to 57% and four studies reported that 9-40% of all malignant lesions was DCIS only.…”

Section: Resultsmentioning

confidence: 99%

“…In all studies, stereotactic guidance was applied. Pijnappel et al (1997) used ultrasound guidance in addition to stereotactic guidance in three cases (4%). Stereotactic biopsy was performed with the patient in prone position by using a 14-gauge needle and a long throw biopsy gun.…”

Section: Meta-analysis Of Diagnostic Accuracymentioning

confidence: 99%

“…Stereotactic biopsy was performed with the patient in prone position by using a 14-gauge needle and a long throw biopsy gun. In four studies all histological diagnoses of large-core needle biopsy specimens were confirmed by additional open biopsy and generally these two procedures took place on the same day (Parker et al, 1991;Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997). In the study of Jackman et al (1999), 295 patients (61%) with a benign diagnosis on large-core needle biopsy did not undergo immediate open biopsy, but mammographic follow-up.…”

Section: Meta-analysis Of Diagnostic Accuracymentioning

confidence: 99%

“…Twenty-five publications were comments, letters or review articles and in 50 studies, the diagnostic performance of large-core needle biopsy was not the object of study. Of the 43 publications addressing the diagnostic accuracy of large-core needle biopsy, five publications were included in the meta-analysis (Parker et al, 1991;Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997;Jackman et al, 1999). (A list of the 38 excluded publications and the reasons for exclusion is available upon request.)…”

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confidence: 99%

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Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

Verkooijen¹,

Buskens

et al. 2000

Br J Cancer

133

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For the evaluation of non-palpable lesions of the breast, image-guided large-core needle biopsies are increasingly replacing needle-localized open breast biopsies. In this study, the diagnostic accuracy of this minimally invasive technique was evaluated by reviewing the available literature. Five cohort studies were included in a meta-analysis. Sensitivity rate, histological agreement between needle biopsy and subsequent surgery or long-term mammographic follow-up and clinical consequences for different disease prevalences were assessed. The sensitivity rate of large-core needle biopsy for the diagnosis of breast cancer was high (97%). The reclassified agreement rate between core biopsy and subsequent surgical biopsy or long-term mammographic follow-up was also high (94%). In case of 20% breast cancer prevalence among women referred after screening (as in the US), the risk of breast cancer despite benign large-core needle biopsy result is less than 1%. In European countries, however, prevalence of breast cancer among referred women is 60–70%. This would result in a risk of breast cancer despite benign large-core needle biopsy result of 4–6%. The results of this meta-analysis indicate that the image guided large-core needle biopsy is a promising alternative for the needle localized breast biopsy. However, additional research is needed to explore the limiting factors of the technique. Without such detailed knowledge, a benign histological diagnosis on large-core needle biopsy in countries with high prevalence of malignancy among referred women should be interpreted with caution. © 2000 Cancer Research Campaign

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Meta-analysis Of Diagnostic Accuracymentioning

confidence: 99%

Section: Meta-analysis Of Diagnostic Accuracymentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

Verkooijen¹,

Buskens

et al. 2000

Br J Cancer

133

View full text Add to dashboard Cite

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Diagnostic accuracy of stereotactic large‐core needle biopsy for nonpalpable breast disease: Results of a multicenter prospective study with 95% surgical confirmation

Verkooijen

2002

Intl Journal of Cancer

140

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Stereotactic large-core needle biopsy is increasingly applied for the diagnosis of nonpalpable breast disease. Our study examines whether this minimally invasive technique is sufficiently accurate to replace surgical breast biopsy. In a prospective multicenter study, 973 consecutive women with 1,029 nonpalpable breast lesions were offered stereotactic 14-gauge needle biopsy. If the needle biopsy yielded breast cancer, the patient was offered therapeutic surgery. Surgical biopsy was proposed in cases of needle biopsies without malignancy. An expert panel reviewed all discrepancies in histologic diagnosis between the needle biopsy and open biopsy. Forty-five patients withdrew from participation and 113 (11%) planned needle biopsy procedures were cancelled. Of the 871 successful biopsy procedures, 95% were confirmed surgically. In 13 cases (1.5%), insufficient material was obtained for histologic assessment. Fifty-five percent of the needle biopsies were diagnosed as malignant (290 invasive cancers, 190 ductal carcinoma in situ). Thirteen of the 322 lesions (4%, 95% CI 2-7%) with a benign needle biopsy diagnosis contained malignancy after surgery. Six of the 26 (23%, 95% CI 9 -44%) lesions with a high-risk diagnosis (atypical ductal or lobular hyperplasia or lobular carcinoma in situ) were diagnosed as malignant after surgery. Five of the 30 lesions containing normal breast tissue held malignancy (17%, 95% CI 6 -35%). Guidelines for the management of different categories of needle biopsy diagnoses were made. Application of these guidelines to the present findings resulted in sensitivity and specificity rates of 97% (95% CI 95-98%) and 99% (95% CI 97-100%), respectively. Stereotactic large-core needle biopsy is an accurate diagnostic instrument for nonpalpable breast disease. It may safely replace needle localised open-breast biopsy provided that high-risk and normal breast tissue diagnoses are followed by needle or openbreast biopsy.

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Sonographic evaluation of mammographically detected microcalcifications without a mass prior to stereotactic core needle biopsy

Cheung

Wan

Chen

et al. 2002

J of Clinical Ultrasound

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In breast lesions that appear as microcalcifications without an associated mass on mammograms, pre-SCNB sonographic re-evaluation with a high-frequency transducer can depict microcalcifications, particularly the clustered ones, and can detect small associated masses. Although the absence of a sonographically detectable mass in areas of mammographically detected microcalcifications does not guarantee the absence of cancer, the presence of an associated mass on sonography should warrant close follow-up in the case of negative results to avoid a delay in the diagnosis of breast carcinoma.

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The diagnostic accuracy of core biopsy in palpable and non-palpable breast lesions

Cited by 55 publications

References 13 publications

Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

Diagnostic accuracy of stereotactic large‐core needle biopsy for nonpalpable breast disease: Results of a multicenter prospective study with 95% surgical confirmation

Sonographic evaluation of mammographically detected microcalcifications without a mass prior to stereotactic core needle biopsy

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