Abstract
Image-guided breast biopsy programs are a clinical reality at breast care centers throughout the world. Because image-guided biopsy is a departure from traditional surgical breast biopsy, the quality of each new image-guided breast biopsy program should be measured. A generalized scheme for quality evaluation will be presented. The most complex part of this scheme is the comparison of tissue samples obtained by image-guided biopsy with tissue samples subsequently obtained during surgery. Because image-guided biopsy programs retrieve histology specimens that are microscopically as valid as histology obtained from open surgery, comparing the histology from an image-guided breast biopsy with the histology from an open surgical biopsy is complex. One cannot use the well-known method of determining false-negative and false-positive rates. In addition, breast histology, itself, is quite complex. Some benign breast disease is quite focal and specific, such as fibroadenomas. Other benign breast disease is diffuse and not very specific, such as fibrocystic abnormalities. Furthermore, malignant breast disease is part of a histology spectrum starting with normal-looking breast tissue with atypical features, progressing to carcinoma in situ, and ending, finally, with infiltrating breast cancer. To illustrate how histological comparisons should be made for breast tissue, published results from a large, nationally funded study will be re-examined using the proposed scheme. Although the breast biopsy, itself, may seem like the hard work of a new breast biopsy program, it is not. After the first year of the program, follow-up of women who have been biopsied is the true, back-breaking, hard work. How a breast center should perform air-tight follow-up will be described.
Highlights
Axillary lymph node dissection has been standard practice for staging invasive breast cancer
Best estimates for where to credit this dramatic drop in death rate place approximately 50% of the credit with improved adjuvant chemotherapy and 50% with mammography
Full field digital mammography (FFDM) had a higher detection rate for ductal carcinoma in situ (DCIS) but no difference was observed for invasive tumours
Summary
Axillary lymph node dissection has been standard practice for staging invasive breast cancer. Aim To assess the feasibility of surgeons performing breast US in symptomatic breast clinics either as an adjunct to triple assessment or on their own for diagnostic and therapeutic purposes. The performance of individual units is monitored to ensure all women have access to an excellent service Aim This project aims to demonstrate how the Liverpool Breast Unit addressed failure to meet the national quality standard for the benign. Method A retrospective review of the records of patients who had undergone benign biopsy (2001–2002) was conducted to establish reasons for surgical referral and suggest corrective measures to enable the unit to meet the standard in the future. Columnar cell change (CCC) is diagnosed on core biopsies performed for indeterminate microcalcification. Method Mammograms of 33 cases with established CCC on core biopsy were reviewed and the radiological features, follow-up imaging and surgical excision histology (if performed) were collated. The results were completed when all units were undergoing assimilation onto the new banding procedures
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
