Ultrasound-guided core needle biopsy of the breast: does frozen section give an accurate diagnosis?

Frede, Thomas; Daniaux, Martin; Ban, Michael; Taucher, Susanne; Schneitter, Alois; Zeimet, Alain G.; Marth, Christian

doi:10.1007/s10549-007-9508-9

Cited by 11 publications

(10 citation statements)

References 30 publications

(30 reference statements)

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“…Out of the cases we obtained 59 frozen section analysis and found 2 false negative results yielding an underdiagnosis and overdiagnosing in 3.5% and 0%, respectively. Our reported data are in accordance with previous reports [10,11]. In the early 1980s Gonzales et al [10] compared the results on frozen sections of Tru-cut ® needle biopsies in 162 cases in a six year period.…”

Section: Discussionsupporting

confidence: 92%

“…Frozen section examination of breast core biopsy specimens is an acceptable technique in the initial evaluation of suspect breast lesions [10,11]. …”

Section: Discussionmentioning

confidence: 99%

“…Providing a definitive diagnosis within a short time reduces patient stress [7,8]. There is some promising evidence from earlier published studies which are focused on this topic yielding an excellent reliability [9-11]. …”

Section: Introductionmentioning

confidence: 99%

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The accuracy of frozen section analysis in ultrasound- guided core needle biopsy of breast lesions

et al. 2009

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BackgroundLimited data are available to evaluate the accuracy of frozen section analysis and ultrasound- guided core needle biopsy of the breast.MethodsIn a retrospective analysis data of 120 consecutive handheldultrasound- guided 14- gauge automated core needle biopsies (CNB) in 109 consecutive patients with breast lesions between 2006 and 2007 were evaluated.ResultsIn our outpatient clinic120 CNB were performed. In 59/120 (49.2%) cases we compared histological diagnosis on frozen sections with those on paraffin sections of CNB and finally with the result of open biopsy. Of the cases 42/59 (71.2%) were proved to be malignant and 17/59 (28.8%) to be benign in the definitive histology. 2/59 (3.3%) biopsies had a false negative frozen section result. No false positive results of the intraoperative frozen section analysis were obtained, resulting in a sensitivity, specificity and positive predicting value (PPV) and negative predicting value (NPV) of 95%, 100%, 100% and 90%, respectively. Histological and morphobiological parameters did not show up relevance for correct frozen section analysis. In cases of malignancy time between diagnosis and definitive treatment could not be reduced due to frozen section analysis.ConclusionThe frozen section analysis of suspect breast lesions performed by CNB displays good sensitivity/specificity characteristics. Immediate investigations of CNB is an accurate diagnostic tool and an important step in reducing psychological strain by minimizing the period of uncertainty in patients with breast tumor.

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Section: Discussionsupporting

confidence: 92%

“…Frozen section examination of breast core biopsy specimens is an acceptable technique in the initial evaluation of suspect breast lesions [10,11]. …”

Section: Discussionmentioning

confidence: 99%

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The accuracy of frozen section analysis in ultrasound- guided core needle biopsy of breast lesions

et al. 2009

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“…It may be emphasized that immediate histological investigation of the biopsy specimens provides valid information about the adequacy of the specimens. Thus, if specimens do not correspond to the radiologically suspected lesion, additional specimens can be obtained during the same session [59]. However, without the experience of multiple large referral centers on this topic and the results of comparative studies as well as considering the longer overall duration, this procedure cannot yet be recommended as a standard.…”

Section: Limitationsmentioning

confidence: 99%

Accuracy of ultrasound-guided, large-core needle breast biopsy

2008

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Ultrasound-guided, large-core needle biopsy (US-LCNB) of suspicious breast lesions is acknowledged as less invasive and less expensive and less time consuming than surgical biopsy, and provides a histologic diagnosis with a comparable high degree. US-LCNB has been proven to help reduce the number of unnecessary surgeries for benign disease. Its limitations, however, are false-negative results and underestimation of disease. Thus, the demand for breast teams is to carefully adhere to the principles of triple assessment and imaging-histologic correlation, and follow-up of lesions with a specific benign histology after biopsy. Also, the acceptance of guidelines and rigorous quality controls help to reliably minimize the delay in the diagnosis of breast cancer in patients with false-negative biopsies. This paper aims to summarize the equipment and methods as well as the benefits and limitations of US-LCNB. Also, guidelines of quality assessment are suggested. Finally, recent developments which may help to overcome the limitations of US-LCNB will be discussed, i.e., directional vacuum-assisted biopsy (VAB), three-dimensional (3D) US-guided biopsy, as well as the use of tissue harmonic imaging (THI) and compound imaging (CI) during biopsy.

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“…Using FNAB, it is not possible to distinguish ductal carcinomas in situ (DCIS) or invasive carcinomas (IC) [8]. The core needle biopsy (CNB) achieves a sensitivity of 85-97% and a specificity that approaches 100% [10,11]. However, a high correlation between imaging and histologic findings is mandatory.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of vacuum-assisted breast biopsy for breast carcinoma: a meta-analysis and systematic review

Liang

Yuan

2010

Breast Cancer Res Treat

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As mammography screening has its limitation in diagnosis in breast carcinoma, minimally invasive procedures offer a better option. We conducted a systematic review to establish the overall value of Vacuum-assisted breast biopsy (VAB) for the diagnosis of breast cancer. After a review and quality assessment of 21 studies, sensitivity, specificity and other measures of accuracy of VAB for evaluating breast lesions were pooled using random-effects models. Summary receiver operating characteristic curves were used to summarize overall accuracy. Underestimate rate of atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) were also calculated. The summary estimates for VAB in diagnosis of breast carcinoma were as follows: sensitivity, 0.981 (95% confidence interval [CI], 0.972-0.987); specificity, 0.999 (95% CI, 0.997-0.999); positive likelihood ratio (PLR), 93.84 (95% CI, 41.55-211.95); negative likelihood ratio, 0.05 (95% CI, 0.03-0.09); diagnostic odds ratio, 1891.7 (95% CI, 683.8-5233.4); underestimate rate of ADH and DCIS were 20.9% (95% CI, 0.177-0.245) and 11.2% (95% CI, 0.098-0.128), respectively. VAB is a highly sensitive and specific biopsy method for evaluating mammographically detected breast in women. To be on the safe side, the diagnosis of ADH in VAB warrants surgical excision.

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Ultrasound-guided core needle biopsy of the breast: does frozen section give an accurate diagnosis?

Cited by 11 publications

References 30 publications

The accuracy of frozen section analysis in ultrasound- guided core needle biopsy of breast lesions

The accuracy of frozen section analysis in ultrasound- guided core needle biopsy of breast lesions

Accuracy of ultrasound-guided, large-core needle breast biopsy

Diagnostic value of vacuum-assisted breast biopsy for breast carcinoma: a meta-analysis and systematic review

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