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dc.contributor.CRUESPUNIVERSIDADE DE ESTADUAL DE CAMPINASpt_BR
dc.identifier.isbnnullpt
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_BR
unicamp.author.externalGonçalves, A.V.B., Instituto Nacional de Câncer - INCA, Rio de Janeiro (RJ), Brazil, Universidade Federal de Sergipe - UFS, Aracaju (SE), Brazilpt
unicamp.author.externalThuler, 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
unicamp.author.externalCarmo, P.A.O., Instituto Nacional de Câncer - INCA, Rio de Janeiro (RJ), Brazil, Instituto Fernandes Figueira, Rio de Janeiro (RJ), Brazilpt
unicamp.author.externalFreitas Lima, C.F., Instituto Nacional de Câncer - INCA, Rio de Janeiro (RJ), Brazil, Universidade Federal Fluminense - UFF, Niterói (RJ), Brazilpt
unicamp.author.externalCipolotti, 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.publishernullpt_BR
dc.date.issued2011pt_BR
dc.identifier.citationRevista Brasileira De Ginecologia E Obstetricia. , v. 33, n. 7, p. 123 - 131, 2011.pt_BR
dc.language.isoenpt_BR
dc.language.isoptpt_BR
dc.description.volume33pt_BR
dc.description.issuenumber7pt_BR
dc.description.initialpage123pt_BR
dc.description.lastpage131pt_BR
dc.rightsabertopt_BR
dc.sourceScopuspt_BR
dc.identifier.issn1007203pt_BR
dc.identifier.doipt_BR
dc.identifier.urlhttp://www.scopus.com/inward/record.url?eid=2-s2.0-80054759838&partnerID=40&md5=66732da33a2a53b2828b9e1241d93bf2pt_BR
dc.date.available2015-06-30T20:33:39Z
dc.date.available2015-11-26T14:51:20Z-
dc.date.accessioned2015-06-30T20:33:39Z
dc.date.accessioned2015-11-26T14:51:20Z-
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.identifier.urihttp://www.repositorio.unicamp.br/handle/REPOSIP/108404
dc.identifier.urihttp://repositorio.unicamp.br/jspui/handle/REPOSIP/108404-
dc.identifier.idScopus2-s2.0-80054759838pt_BR
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