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首页> 外文期刊>Indian Journal of Medical and Paediatric Oncology >Needle core biopsy for breast lesions: An audit of 467 needle core biopsies
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Needle core biopsy for breast lesions: An audit of 467 needle core biopsies

机译：乳腺病变的针芯活检：对467针芯活检的审核

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Background:Breast cancer is the commonest cancer among women in urban India. Triple assessment includes clinical, radiological and cytological assessment of breast lesions. Guided core needle biopsy has replaced fine needle aspiration cytology in most of the western countries. In resource poor countries FNAC is still a very valuable and cost effective method to diagnose breast lesions. Pitfalls include increased rates of non diagnostic smears, and inadequate smears. Further procedures may be required and this increases the cost, anxiety and delay in diagnosis.Aims:The aim of this study is to analyze the concordance of radiological and histopathology findings in BI-RADS category 3,4,5 lesions following a core biopsy.Materials and Methods:Data was retrospectively collected from consecutive symptomatic and opportunistic screen detected patients with abnormalities who underwent ultrasound guided interventional procedures from Jan 2010 to Aug 2011. Symptomatic patients underwent clinical examination, mammogram and breast ultrasound. Women under 35 years of age had only breast ultrasound. Core biopsy was performed under ultrasound guidance or clinically by a breast surgeon/ radiologist for BI-RADS category 3,4,5 lesions.Statistical Methods:Chi square test was done to show the strength of association of imaging findings and histopathology results of core biopsy.Results:437 patients were symptomatic and 30 patients had screen detected abnormalities. The positive predictive value for BI-RADS 5 lesions for malignancy is 93.25% and the negative predictive value of BI-RADS category 3 lesions for cancer is 98.4%. False negative diagnosis on core biopsy was 0.85%. We were able to defer surgery in 60% of the patients with a clear radiological and pathological benign diagnosis.Conclusion:The PPV and NPV for cancer is high with needle core biopsy in BI-RADS 3,4,5 lesions. Where there is no discordance between clinical, radiology and pathology findings, surgery can be avoided in benign lesions. While in resource poor countries FNAC continues to be a valuable method in the diagnosis of palpable and non palpable breast lesions, the practice of needle core biopsy provides the most accurate and optimal diagnostic information.
机译：背景：乳腺癌是印度城市女性中最常见的癌症。三重评估包括对乳腺病变的临床，放射学和细胞学评估。在大多数西方国家，引导式芯针活检已取代了细针穿刺细胞学检查。在资源贫乏的国家，FNAC仍然是诊断乳房病变的一种非常有价值且具有成本效益的方法。陷阱包括非诊断性涂片率增加和涂片不足。可能需要进一步的程序，这会增加诊断的成本，焦虑和延迟。目的：本研究的目的是分析核心活检后BI-RADS 3、4、5类病变的放射学和组织病理学发现的一致性。资料与方法：回顾性收集2010年1月至2011年8月接受超声引导介入治疗的连续有症状和机会性筛查的异常患者的数据。对有症状患​​者进行临床检查，乳房X线照片和乳房超声检查。 35岁以下的女性只有乳房超声检查。核心活检是在超声指导下或由乳腺外科医生/放射科医生对BI-RADS 3、4、5类病变进行的。统计学方法：进行卡方检验以显示影像学发现与核心活检的组织病理学结果的关联强度结果：437例有症状，有30例筛查异常。 BI-RADS 5病变对恶性肿瘤的阳性预测值为93.25％，BI-RADS 3类病变对癌症的阴性预测值为98.4％。核心活检的假阴性诊断为0.85％。我们能够推迟60％的患者在明确放射学和病理学良性诊断的情况下推迟手术。结论：BI-RADS 3、4、5病变的针头活检对癌症的PPV和NPV较高。如果在临床，放射学和病理学检查结果之间没有不一致之处，则可以避免在良性病变中进行手术。在资源匮乏的国家中，FNAC仍然是诊断可触及不可触及的乳腺病变的有价值的方法，而针芯活检的做法可提供最准确和最佳的诊断信息。

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