Abstract
BackgroundLimited data are available to evaluate the accuracy of frozen section analysis and ultrasound- guided core needle biopsy of the breast.MethodsIn a retrospective analysis data of 120 consecutive handheldultrasound- guided 14- gauge automated core needle biopsies (CNB) in 109 consecutive patients with breast lesions between 2006 and 2007 were evaluated.ResultsIn our outpatient clinic120 CNB were performed. In 59/120 (49.2%) cases we compared histological diagnosis on frozen sections with those on paraffin sections of CNB and finally with the result of open biopsy. Of the cases 42/59 (71.2%) were proved to be malignant and 17/59 (28.8%) to be benign in the definitive histology. 2/59 (3.3%) biopsies had a false negative frozen section result. No false positive results of the intraoperative frozen section analysis were obtained, resulting in a sensitivity, specificity and positive predicting value (PPV) and negative predicting value (NPV) of 95%, 100%, 100% and 90%, respectively. Histological and morphobiological parameters did not show up relevance for correct frozen section analysis. In cases of malignancy time between diagnosis and definitive treatment could not be reduced due to frozen section analysis.ConclusionThe frozen section analysis of suspect breast lesions performed by CNB displays good sensitivity/specificity characteristics. Immediate investigations of CNB is an accurate diagnostic tool and an important step in reducing psychological strain by minimizing the period of uncertainty in patients with breast tumor.
Highlights
Limited data are available to evaluate the accuracy of frozen section analysis and ultrasound- guided core needle biopsy of the breast
Percutaneous image- guided core needle biopsies (CNB) has become an alternative to fine needle aspiration cytology (FNAC) and to the open surgical biopsy
In this article we briefly review the results of US- guided CNB and frozen section analysis of the specimens in order to require a rapid diagnosis and to reduce psychological strain by minimizing the period of uncertainty in patients with breast tumor
Summary
Limited data are available to evaluate the accuracy of frozen section analysis and ultrasound- guided core needle biopsy of the breast. Percutaneous image- guided CNB has become an alternative to fine needle aspiration cytology (FNAC) and to the open surgical biopsy. FNAC is a relevant test, mainly feasible for cystic lesions [1], surgical open biopsy is more invasive [2] and expensive [3]. Ultrasound- guided automated core biopsy was first described by Parker et al in 1993 [4]. Other investigators have demonstrated that ultrasoundguided 14- gauge automated core biopsy is safe, fast, accurate, and costsaving [2,5,6]. Its application in the evaluation of breast lesions is excellent, being limited only by the fatty content of the biopsy material. In the case of infiltrating breast carcinoma, can one establish the accurate diagnosis but other observations, such as histologic subgroup and the degree of differentiation can be obtained
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