J Ultrason. 2017 Dec;17(71):267-274. doi: 10.15557/JoU.2017.0039. Epub 2017 Dec 29.
Fine-needle versus core-needle biopsy - which one to choose in preoperative assessment of focal lesions in the breasts? Literature review.
Journal of ultrasonography
Ewa Łukasiewicz, Agnieszka Ziemiecka, Wiesław Jakubowski, Jelena Vojinovic, Magdalena Bogucevska, Katarzyna Dobruch-Sobczak
Affiliations
Affiliations
- Department of Medical Imaging, Mazovia Brodnowski Hospital, Warsaw, Poland.
- Department of Ultrasonography and Mammography, Mazovia Brodnowski Hospital, Warsaw, Poland.
- Department of Pediatric Rheumatology, Clinical Center, Faculty of Medicine, University of Nis, Serbia.
- Department of Radiology, City General Hospital "8 September", Skopje, Macedonia.
- Second Department of Radiology, Center of Oncology - Institute, Warsaw, Poland.
PMID: 29375902
PMCID: PMC5769667 DOI: 10.15557/JoU.2017.0039
Abstract
AIM: The aim of the study was to review two techniques that can be used to verify focal lesions in the breasts: fine-needle aspiration biopsy and core-needle biopsy.
MATERIAL AND METHODS: Fifty-five articles (original papers and reviews), half of them published within the past 5 years, were included in the analysis. The authors also took their own experience into account.
RESULTS: Pre-operative assessment of focal lesions in the breasts is crucial in the planning of further therapeutic management. The role of fine-needle aspiration biopsy has been reduced lately due to its low sensitivity and specificity as well as a high rate of non-diagnostic, suspicious and false negative results. This method does not enable one to differentiate between in situ and invasive disease. Currently, fine-needle biopsy is recommended for cystic lesions, suspected of being recurrences in the chest wall, and lymph node metastases. Core-needle biopsy is the basic diagnostic method of breast lesions. According to the recommendations of the Polish Ultrasound Society and American College of Radiology, BIRADS 4 and 5 lesions should be evaluated histopathologically. Core-needle biopsy makes it possible to establish a final diagnosis more frequently than fine-needle biopsy, both in the case of benign and malignant lesions. It delivers more information about the nature of a tumor (mutation of HER-2, estrogen and progesterone receptors and Ki-67 index). Its limitations include: underestimation of invasion and failure to recognize the components of ductal carcinoma in situ in papillary and atypical lesions. Single fine-needle aspiration biopsy is inexpensive, but when considering the cost of further diagnosis due to non-diagnostic, suspicious and atypical results, this method generates high additional costs.
CONCLUSIONS: Microscopic verification of focal breast lesions is crucial for further therapeutic decisions. It has been proven that histopathological verification is more accurate and has more advantages than cytological assessment.
Keywords: atypical ductal hyperplasia; core-needle biopsy; ductal carcinoma in situ; fine-needle aspiration biopsy; papillary lesions
References
- Radiology. 2003 May;227(2):549-55 - PubMed
- AJR Am J Roentgenol. 2014 Jun;202(6):1389-94 - PubMed
- J Clin Pathol. 2012 Apr;65(4):287-92 - PubMed
- Cancer Imaging. 2012 Oct 31;12:488-96 - PubMed
- Ultraschall Med. 2012 Oct;33(5):447-54 - PubMed
- Br J Surg. 2013 Dec;100(13):1756-63 - PubMed
- J Med Imaging Radiat Oncol. 2017 Feb;61(1):29-33 - PubMed
- J Breast Cancer. 2011 Mar;14(1):1-7 - PubMed
- World J Surg Oncol. 2011 Aug 11;9:87 - PubMed
- Diagn Cytopathol. 2003 Jun;28(6):329-34 - PubMed
- Cancer. 2016 Sep 15;122(18):2819-27 - PubMed
- Ann Surg Oncol. 2009 Feb;16(2):281-4 - PubMed
- J Am Coll Surg. 2012 Mar;214(3):280-7 - PubMed
- Cell Rep. 2016 Jul 26;16(4):1166-1179 - PubMed
- Br J Cancer. 2006 Jul 3;95(1):62-6 - PubMed
- Breast. 2007 Jun;16(3):303-6 - PubMed
- Cancer Prev Res (Phila). 2014 Feb;7(2):211-7 - PubMed
- Acta Oncol. 2008;47(6):1037-45 - PubMed
- Pathol Oncol Res. 2015 Jul;21(3):535-46 - PubMed
- J Ultrason. 2012 Sep;12(50):245-61 - PubMed
- Diagn Cytopathol. 2011 May;39(5):380-8 - PubMed
- Am J Med Sci. 2012 Jul;344(1):28-31 - PubMed
- Diagn Interv Radiol. 2013 Sep-Oct;19(5):371-6 - PubMed
- Acta Radiol. 2003 Jul;44(4):387-91 - PubMed
- Radiology. 2011 Jul;260(1):119-28 - PubMed
- Cancer. 1996 Aug 15;78(4):773-7 - PubMed
- Radiology. 1993 May;187(2):507-11 - PubMed
- Radiology. 2003 Mar;226(3):779-82 - PubMed
- Pathology. 2007 Aug;39(4):391-5 - PubMed
- Int J Surg Pathol. 2014 Dec;22(8):695-8 - PubMed
- Ultrasonography. 2014 Apr;33(2):128-35 - PubMed
- Cancer. 2013 Mar 1;119(5):1073-9 - PubMed
- World J Surg. 2001 Jun;25(6):767-72 - PubMed
- Am J Clin Pathol. 2012 Jul;138(1):72-8 - PubMed
- AJR Am J Roentgenol. 2000 Nov;175(5):1341-6 - PubMed
- Breast Cancer Res Treat. 2010 Aug;123(1):1-8 - PubMed
- Pathol Int. 2012 Feb;62(2):120-6 - PubMed
- Breast Cancer Res. 2003;5(5):254-7 - PubMed
- Gland Surg. 2014 May;3(2):120-7 - PubMed
- Acta Radiol. 2005 Nov;46(7):690-5 - PubMed
- Diagn Cytopathol. 2015 Dec;43(12 ):978-86 - PubMed
- Breast. 2013 Aug;22(4):537-42 - PubMed
- Ann Surg Oncol. 2012 Oct;19(10):3264-9 - PubMed
- Cancer. 1998 Feb 15;82(4):679-88 - PubMed
- Br J Radiol. 2011 Oct;84(1006):869-74 - PubMed
- Eur J Radiol. 2010 Jun;74(3):519-24 - PubMed
- J Clin Pathol. 2001 Feb;54(2):121-5 - PubMed
- Am J Surg Pathol. 2006 Jun;30(6):665-72 - PubMed
Publication Types