Can core biopsy be used instead of surgical biopsy in the diagnosis and prognostic factor analysis of breast carcinoma?
Can core biopsy be used instead of surgical biopsy in the diagnosis and prognostic factor analysis of breast carcinoma?
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DOI：
10.3816/cbc.2007.n.041
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发表时间：
2007-10-01
影响因子：
3.1
通讯作者：
Yamac, Deniz
中科院分区：
文献类型：
--
作者：
Ozdemir, Aysegul;Voyvoda, Nuray Kadioglu;Yamac, Deniz
目的：探讨超声引导下乳癌芯针活检的疗效及预后因素分析，为制定整体治疗策略提供依据。患者和方法：连续一系列不可触及和可触及的乳腺癌构成了我们的研究组(n=201个病变，平均大小为20.4 mm)，平均核心样本数为3.4。经核心活检诊断为恶性病变的患者接受了治疗性手术切除。比较组织学类型、分级、雌激素受体(ER)、孕激素受体(PGRs)和c-erbB2水平。影响管理战略的ER、PGR和c-erbB2的临界值分别被选为10%、10%和50%。结果：85个病灶(42.3%)为恶性病变，平均大小为18.4 mm。其中11例不能手术，13例在其他机构手术切除。在同一机构(平均肿瘤大小18.6 mm，范围6-60 mm)对61个病灶的核心标本和手术切除标本进行了评估。组织学分型符合率85.2%(52/61)，分级符合率168.8%(33/48)，ER符合率90%(27/30)，PGR符合率86.7%(26/30)，c-erbB2符合率79.3%(23/29)。选择合适的采样部位是至关重要的，尤其是在确定可靠的ER、PGR和c-erbB2水平方面。结论：乳癌核心针活检与手术活检疗效相当，可用于整体治疗计划。然而，在超声引导下，应确保选择合适的采样地点。
Purpose: The aim of this article was to investigate the efficacy of ultrasonography-guided core needle biopsy and prognostic factor analysis of breast cancer to plan overall treatment strategy. Patients and Methods: A consecutive series of nonpalpable and palpable breast cancers constituted our study group (n= 201 lesions; mean size, 20.4 mm) Mean number of core samples was 3.4. Malignant lesions diagnosed with core biopsy underwent therapeutic surgical excision. Core biopsy and surgical excisions were compared for histologic type, grade, estrogen receptors (ERs), progesterone receptors (PgRs), and c-erbB2 levels. Cutoff values for ER, PgR, and c-erbB2 affecting the management strategy were selected as 10%, 10%, and 50%, respectively. Results: Eighty-five lesions (42.3%) were malignant in core biopsy (mean size, 18.4 mm). 1 Among these, 11 were inoperable and 13 were surgically excised at other institutions. In 61 lesions, core and surgical excision specimens were evaluated in the same institution (mean tumor size, 18.6 mm; range 6-60 mm). Concordance between the 2 biopsy methods was 85.2% (52 of 61) for histologic type of tumor, 1 68.8% (33 of 48) for tumor grade, 90% (27 of 30) for ER, 86.7% (26 of 30) for PgR, and 79.3% (23 of 29) for c-erbB2 levels. Appropriate site selection for sampling was indicated to be of paramount importance, I especially in determining reliable ER, PgR, and c-erbB2 levels. Conclusion: Core needle biopsy of breast cancer is equally effective compared wth surgical biopsy and can be used in overall treatment planning. However, appropriate site selection for sampling should be guaranteed using ultrasonographic guidance.