Please use this identifier to cite or link to this item:
Full metadata record
DC FieldValueLanguage
dc.typeArtigo de periódicopt_BR
dc.titleUnderestimation Of Malignancy Of Core Needle Biopsy For Nonpalpable Breast Lesions [grau De Subestimação Histopatológica Por Core Biopsy De Lesões Não Palpáveis Da Mama]pt_BR
dc.contributor.authorGoncalves A.V.B.pt_BR
dc.contributor.authorThuler L.C.S.pt_BR
dc.contributor.authorKestelman F.P.pt_BR
dc.contributor.authorCarmo P.A.O.pt_BR
dc.contributor.authorFreitas Lima C.F.pt_BR
dc.contributor.authorCipolotti R.pt_BR
unicamp.authorKestelman, F.P., Instituto Nacional de Câncer - INCA, Rio de Janeiro (RJ), Brazil, Universidade Estadual de Campinas - UNICAMP, Campinas (SP), Brazil, Clínica Felipe Mattoso, Rio de Janeiro (RJ), Brazilpt_BRçalves, A.V.B., Instituto Nacional de Câncer - INCA, Rio de Janeiro (RJ), Brazil, Universidade Federal de Sergipe - UFS, Aracaju (SE), Brazilpt, L.C.S., Instituto Nacional de Câncer - INCA, Rio de Janeiro (RJ), Brazil, Universidade Federal do Estado do Rio de Janeiro - UNIRIO, Rio de Janeiro (RJ), Brazilpt, P.A.O., Instituto Nacional de Câncer - INCA, Rio de Janeiro (RJ), Brazil, Instituto Fernandes Figueira, Rio de Janeiro (RJ), Brazilpt Lima, C.F., Instituto Nacional de Câncer - INCA, Rio de Janeiro (RJ), Brazil, Universidade Federal Fluminense - UFF, Niterói (RJ), Brazilpt, R., Department of Medicine, Federal University of Sergipe - UFS, Aracaju (SE), Brazilpt
dc.description.abstractPURPOSE: To determine the rate of underestimation of an image-guided core biopsy of nonpalpable breast lesions, with validation by histologic examination after surgical excision. METHODS: We retrospectively reviewed 352 biopsies from patients who were submitted to surgery from February 2000 to December 2005, and whose histopathologic findings were recorded in the database system. Results were compared to surgical findings and underestimation rate was determined by dividing the number of lesions that proved to be carcinomas at surgical excision by the total number of lesions evaluated with excisional biopsy. Clinical, imaging, core biopsy and pathologic features were analyzed to identify factors that affect the rate of underestimation. The degree of agreement between the results was obtained by the percentage of agreement and Cohen's kappa coefficient. The association of variables with the underestimation of the diagnosis was determined by the chi-square, Fisher exact, ANOVA and Mann-Whitney U tests. The risk of underestimation was measured by the relative risk (RR) together with the respective 95% confidence intervals (95%CI). RESULTS: Inconclusive core biopsy findings occurred in 15.6% of cases. The histopathological result was benign in 26.4%, a high-risk lesion in 12.8% and malignant in 45.2%. There was agreement between core biopsy and surgery in 82.1% of cases (kappa=0.75). The false-negative rate was 5.4% and the lesion was completely removed in 3.4% of cases. The underestimation rate was 9.1% and was associated with BI-RADS® category 5 (p=0,01), microcalcifications (p <0.001) and stereotactic guidance (p=0.002). All underestimated cases were less than 20 mm in diameter and there were at least five fragments. The underestimation rate of high-risk lesions was 31.1%, 41.2% for atypical ductal hyperplasia, 31.2% for papillary lesions, 16.7% for phyllodes tumor, and 41.9% for ductal carcinoma in situ. CONCLUSIONS: The core breast biopsy under image guidance is a reliable procedure but the recommendation of surgical excision of high-risk lesions detected in the core biopsy remains since it was not possible to assess clinical, imaging, core biopsy and pathologic features that could predict underestimation and avoid excision. Representative samples are much more important than number of fragments.en
dc.relation.ispartofRevista Brasileira de Ginecologia e Obstetriciapt_BR
dc.identifier.citationRevista Brasileira De Ginecologia E Obstetricia. , v. 33, n. 7, p. 123 - 131, 2011.pt_BR
dc.description.provenanceMade available in DSpace on 2015-06-30T20:33:39Z (GMT). No. of bitstreams: 1 2-s2.0-80054759838.pdf: 584382 bytes, checksum: 04d67b1550c3654f6fabc26d7690b365 (MD5) Previous issue date: 2011en
dc.description.provenanceMade available in DSpace on 2015-11-26T14:51:20Z (GMT). No. of bitstreams: 1 2-s2.0-80054759838.pdf: 584382 bytes, checksum: 04d67b1550c3654f6fabc26d7690b365 (MD5) Previous issue date: 2011en
dc.description.referenceThuler, L.C., Considerações sobre a prevenção do câncer de mama feminino (2003) Rev Bras Cancerol, 49 (4), pp. 227-238pt_BR
dc.description.referenceFitzal, F., Sporn, E.P., Draxler, W., Mittlböck, M., Taucher, S., Rudas, M., Preoperative core needle biopsy does not increase local recurrence rate in breast cancer patients (2006) Breast Cancer Res Treat, 97 (1), pp. 9-15pt_BR
dc.description.reference, Brasil. Ministério da Saúde. Instituto Nacional de Câncer [Internet]. Estimativa 2010: incidência de câncer no Brasil. Rio de Janeiro: INCApt_BR
dc.description.reference2010 [citado 2010 Nov 20]. Disponível emFahrbach, K., Sledge, I., Cella, C., Linz, H., Ross, S.D., A comparison of the accuracy of two minimally invasive breast biopsy methods: A systematic literature review and meta-analysis (2006) Arch Gynecol Obstet, 274 (2), pp. 63-73pt_BR
dc.description.referenceBianchi, S., Caini, S., Cattani, M.G., Vezzosi, V., Biancalani, M., Palli, D., Diagnostic concordance in reporting breast needle core biopsies using the B classifcation - A panel in Italy (2009) Pathol Oncol Res, 15 (4), pp. 725-732pt_BR
dc.description.referenceMoutinho, M.S.P., Elias, S., Kemp, C., Nazário, A.C.P., Baracat, E.C., Acurácia diagnóstica da biópsia percutânea com agulha grossa orientada por estereotaxia nas lesões mamárias categoria BI-RADS® 4 (2007) Rev Bras Ginecol Obstet, 29 (12), pp. 608-613pt_BR
dc.description.referenceAbreu-e-Lima, M.C., Maranhão, N., Almeida, V., Melo, C.B., Araújo, E., Abreu-e-Lima, M., Comparação entre fragmentos obtidos com agulhas de calibres 14 e 12 em "core biopsy" estereotáxica de lesões mamárias impalpáveis: Diferenças entre o tamanho dos fragmentos e freqüência dos tipos de lesões diagnosticadas (2001) Radiol Bras, 34 (5), pp. 255-260pt_BR
dc.description.referenceZannis, V.J., Aliano, K.M., The evolving practice pattern of the breast surgeon with disappearance of open biopsy for nonpalpable lesions (1998) Am J Surg, 176 (6), pp. 525-528pt_BR
dc.description.referenceSteinmacher, D.I., Kemp, C., Nazário, A.C.P., Avaliação da biópsia percutânea por agulha grossa com propulsor automático na propedêutica de lesões palpáveis e não-palpáveis da mama (2010) Rev Bras Mastologia, 20 (1), pp. 3-9pt_BR
dc.description.referenceDillon, M.F., Quinn, C.M., McDermott, E.W., O'Doherty, A., O'Higgins, N., Hill, A.D., Diagnostic accuracy of core biopsy for ductal carcinoma in situ and its implications for surgical practice (2006) J Clin Pathol, 59 (7), pp. 740-743pt_BR
dc.description.referenceCiatto, S., Houssami, N., Ambrogetti, D., Bianchi, S., Bonardi, R., Brancato, B., Accuracy and underestimation of malignancy of breast core needle biopsy: The Florence experience of over 4000 consecutive biopsies (2007) Breast Cancer Res Treat, 101 (3), pp. 291-297pt_BR
dc.description.referenceCipolla, C., Fricano, S., Vieni, S., Amato, C., Napoli, L., Graceffa, G., Validity of needle core biopsy in the histological characterisation of mammary lesions (2006) Breast, 15 (1), pp. 76-80pt_BR
dc.description.referenceLiberman, L., Goodstine, S.L., Dershaw, D.D., Morris, E.A., Latrenta, L.R., Abramson, A.F., One operation after percutaneous diagnosis of nonpalpable breast cancer: Frequency and associated factors (2002) AJR Am J Roentgenol, 178 (3), pp. 673-679pt_BR
dc.description.referenceDarling, M.L., Smith, D.N., Lester, S.C., Kaelin, C., Selland, D.L., Denison, C.M., Atypical ductal hyperplasia and ductal carcinoma in situ as revealed by large-core needle breast biopsy: Results of surgical excision (2000) AJR Am J Roentgenol, 175 (5), pp. 1341-1346pt_BR
dc.description.referenceFadare, O., Clement, N.F., Ghofrani, M., High and intermediate grade ductal carcinoma in-situ of the breast: A comparison of pathologic features in core biopsies and excisions and an evaluation of core biopsy features that may predict a close or positive margin in the excision (2009) Diagn Pathol, 4, p. 26pt_BR
dc.description.referenceIwase, T., Takahashi, K., Gomi, N., Horii, R., Akiyama, F., Present state of and problems with core needle biopsy for non-palpable breast lesions (2006) Breast Cancer, 13 (1), pp. 32-37pt_BR
dc.description.referenceJackman, R.J., Nowels, K.W., Rodriguez-Soto, J., Marzoni, F.A., Finkelstein, S.I., Shepard, M.J., Stereotactic, automated, large-core needle biopsy of nonpalpable breast lesions: False-negative and histologic underestimation rates after long-term follow-up (1999) Radiology, 210 (3), pp. 799-805pt_BR
dc.description.referenceJackman, R.J., Burbank, F., Parker, S.H., Evans, W.P., Lechner, M.C., Richardson, T.R., Stereotactic breast biopsy of nonpalpable lesions: Determinants of ductal carcinoma in situ underestimation rates (2001) Radiology, 218 (2), pp. 497-502pt_BR
dc.description.referenceJang, M., Cho, N., Moon, W.K., Park, J.S., Seong, M.H., Park, I.A., Underestimation of atypical ductal hyperplasia at sonographically guided core biopsy of the breast (2008) AJR Am J Roentgenol, 191 (5), pp. 1347-1351pt_BR
dc.description.referenceMargenthaler, J.A., Duke, D., Monsees, B.S., Barton, P.T., Clark, C., Dietz, J.R., Correlation between core biopsy and excisional biopsy in breast high-risk lesions (2006) Am J Surg, 192 (4), pp. 534-537pt_BR
dc.description.referenceRosen, E.L., Bentley, R.C., Baker, J.A., Soo, M.S., Imaging-guided core needle biopsy of papillary lesions of the breast (2002) AJR Am J Roentgenol, 179 (5), pp. 1185-1192pt_BR
dc.description.referenceRutstein, L.A., Johnson, R.R., Poller, W.R., Dabbs, D., Groblewski, J., Rakitt, T., Predictors of residual invasive disease after core needle biopsy diagnosis of ductal carcinoma in situ (2007) Breast J, 13 (3), pp. 251-257pt_BR
dc.description.referenceSchueller, G., Jaromi, S., Ponhold, L., Fuchsjaeger, M., Memarsadeghi, M., Rudas, M., US-guided 14-gauge core-needle breast biopsy: Results of a validation study in 1352 cases (2008) Radiology, 248 (2), pp. 406-413pt_BR
dc.description.referenceShin, H.J., Kim, H.H., Kim, S.M., Yang, H.R., Sohn, J.H., Kwon, G.Y., Papillary lesions of the breast diagnosed at percutaneous sonographically guided biopsy: Comparison of sonographic features and biopsy methods (2008) AJR Am J Roentgenol, 190 (3), pp. 630-636pt_BR
dc.description.referenceSydnor, M.K., Wilson, J.D., Hijaz, T.A., Massey, H.D., de Shaw Paredes, E.S., Underestimation of the presence of breast carcinoma in papillary lesions initially diagnosed at core-needle biopsy (2007) Radiology, 242 (1), pp. 58-62pt_BR
dc.description.referenceTseng, H.S., Chen, Y.L., Chen, S.T., Wu, Y.C., Kuo, S.J., Chen, L.S., The management of papillary lesion of the breast by core needle biopsy (2009) Eur J Surg Oncol, 35 (1), pp. 21-24pt_BR
dc.description.referenceWu, Y.C., Chen, D.R., Kuo, S.J., Personal experience of ultrasound-guided 14-gauge core biopsy of breast tumor (2006) Eur J Surg Oncol, 32 (7), pp. 715-718pt_BR
dc.description.referenceYouk, J.H., Kim, E.K., Kim, M.J., Atypical ductal hyperplasia diagnosed at sonographically guided 14-gauge core needle biopsy of breast mass (2009) AJR Am J Roentgenol, 192 (4), pp. 1135-1141pt_BR
dc.description.referenceUsami, S., Moriya, T., Kasajima, A., Suzuki, A., Ishida, T., Sasano, H., Pathological aspects of core needle biopsy for non-palpable breast lesions (2005) Breast Cancer, 12 (4), pp. 272-278pt_BR
dc.description.referenceKuo, Y.L., Chang, T.W., Can concurrent core biopsy and fne needle aspiration biopsy improve the false negative rate of sonographically detectable breast lesions? (2010) BMC Cancer, 10, p. 371pt_BR
dc.description.referenceChae, B.J., Lee, A., Song, B.J., Jung, S.S., Predictive factors for breast cancer in patients diagnosed atypical ductal hyperplasia at core needle biopsy (2009) World J Surg Oncol, 7, p. 77pt_BR
dc.description.referenceLondero, V., Zuiani, C., Linda, A., Battigelli, L., Brondani, G., Bazzocchi, M., Borderline breast lesions: Comparison of malignancy underestimation rates with 14-gauge core needle biopsy versus 11-gauge vacuum-assisted device (2011) Eur Radiol, 21 (6), pp. 1200-1206pt_BR
Appears in Collections:Unicamp - Artigos e Outros Documentos

Files in This Item:
File SizeFormat 
2-s2.0-80054759838.pdf570.69 kBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.