Pathological aspects of core needle biopsy for non-palpable breast lesions.
Pathological aspects of core needle biopsy for non-palpable breast lesions.
复制标题
DOI：
10.2325/jbcs.12.272
复制
发表时间：
2005-01-01
期刊：
影响因子：
--
通讯作者：
Ohuchi, Noriaki
中科院分区：
文献类型：
--
作者：
Usami, Shin;Moriya, Takuya;Ohuchi, Noriaki
近年来，非可触及或非侵袭性乳腺癌的发病率有所增加。因此，选择获取病理材料的程序的标准已经改变。细针穿刺活检细胞学（FNA）和核心针活检（CNB）都是检测乳腺癌的可靠方法。然而，对于非可触及病变，CNB的诊断准确性更高。FNA的主要限制是采样不足率高和无法确定侵入性。CNB是手术活检的替代方案，CNB可以避免大量患者进行多余的手术活检。除了准确的组织学诊断外，从CNB中获得预后信息也很有意义，特别是对于考虑术前（新辅助）治疗的患者。CNB提供了有关组织学类型和分级的有用信息。然而，CNB的一个不可避免的问题是对入侵的低估。另一方面，CNB与手术切除之间，尤其是雌激素受体（ER）和孕激素受体（PR）有很好的一致性。CNB的几个方面仍有争议，如通过CNB诊断乳头状病变，CNB后肿瘤细胞移位的问题，以及CNB的小叶瘤变（LN）的处理。
Recently, the incidence of non-palpable or noninvasive breast cancer has increased. Consequently, criteria for choosing procedures to obtain pathological materials had changed. Fine needle aspiration biopsy cytology (FNA) and core needle biopsy (CNB) are both reliable procedures for detecting breast cancer. However, for non-palpable lesions, the diagnostic accuracy of CNB is higher. The main limits of FNA are the high rate of insufficient sampling and inability to determine invasiveness. CNB is an established alternative to surgical biopsy, and CNB can avoid excess surgical biopsies in a large number of patients. In addition to accurate histological diagnosis, there is interest in obtaining prognostic information from CNB, especially for patients being considered for preoperative (neoadjuvant) therapy. CNB provides useful information about histologic type and grade. However, an unavoidable problem of CNB is underestimation of invasion. On the other hand, there is good concordance in particular for estrogen receptor (ER) and progesterone receptor (PR) between CNB and surgical excision. Several aspects of CNB remains controversial, such as diagnosing papillary lesions by CNB, problems regarding tumor cell displacement after CNB, and management of lobular neoplasia (LN) on CNB.