Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease and the basis for the treatment planning. The concordance rate between CNB and surgical excision specimen in determination of histological grade (HG) varies widely across literature, ranging from 59-91%. The aim of our study was to investigate the level of concordance between CNB and surgical excision specimen for the determination of HG for breast cancer patients. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. The concordance level between core needle biopsy and surgical resection specimen for overall histologic grading was 73%: for tubule formation – 71%, for nuclear pleomorphism – 91%, for the mitotic index – 59%. Our study shows that our institution’s histologic grading of CNBs and surgical excisions shows a fairly good correlation and is useful for the planning of treatment.
REFERENCES(55)
1.
World Health Organization (WHO). Breast Cancer: prevention and control. Available at: http://www.who.int/cancer/dete... (accessed on January 9, 2018).
Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136: E359-E386.
Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin 2021; 71: 209-249.
Kohler BA, Sherman RL, Howlander N, et al. Annual Report to the Nation on the Status of Cancer, 1975-2011, Featuring Incidence of Breast Cancer Subtypes by Race/Ethnicity, Poverty, and State. J Natl Cancer Inst 2015; 107: djv048.
Senkus E, Kyriakides S, Ohno S, et al.; ESMO Guidelines Committee. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26: 8-30.
Wang M, He X, Chang Y, et al. A sensitivity and specificity comparison of fine needle aspiration cytology and core needle biopsy in evaluation of suspicious breast lesions: A systematic review and meta-analysis. Breast 2017; 31: 157-166.
Blamey RW, Ellis IO, Pinder SE, et al. Survival of invasive breast cancer according to the Nottingham Prognostic Index in cases diagnosed in 1990-1999. Eur J Cancer 2007; 43: 1548-1555.
Bruening W, Fontanarosa J, Tipton K, et al. Systematic review: comparative effectiveness of core-needle and open surgical biopsy to diagnose breast lesions. Ann Intern Med 2010; 152: 238-246.
Dahlstrom JE, Jain S, Sutton T, et al. Diagnostic accuracy of stereotactic core biopsy in a mammographic breast cancer screening programme. Histopathology 1996; 28: 421-427.
Di Loreto C, Puglisi F, Rimondi G, et al. Large core biopsy for diagnostic and prognostic evaluation of invasive breast carcinomas. Eur J Cancer 1996; 32A: 1693-1700.
Shanmugalingam A, Hitos K, Hegde S, et al. Concordance between core needle biopsy and surgical excision for breast cancer tumor grade and biomarkers. Breast Cancer Res Treat 2022; 193: 151-159.
Asogan AB, Hong GS, Arni Prabhakaran SK. Concordance between core needle biopsy and surgical specimen for oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 status in breast cancer. Singapore Med J 2017; 58: 145-149.
Pijnappel RM, van Dalen A, Borel Rinkes IH, et al. The diagnostic accuracy of core biopsy in palpable and non-palpable breast lesions. Eur J Radiol 1997; 24: 120-123.
Crowe JP, Patrick RJ, Rybicki LA, et al. Does ultrasound core breast biopsy predict histologic finding on excisional biopsy? Am J Surg 2003; 186: 397-399.
Kwok TC, Rakha EA, Lee AH, et al. Histological grading of breast cancer on needle core biopsy: the role of immunohistochemical assessment of proliferation. Histopathology 2010; 57: 212-219.
Rakha EA, El-Sayed ME, Lee AH, et al. Prognostic significance of Nottingham histologic grade in invasive breast carcinoma. J Clin Oncol 2008; 26: 3153-3158.
Amat S, Penault-Llorca F, Cure H, et al. Scarff-Bloom-Richardson (SBR) grading: a pleiotropic marker of chemosensitivity in invasive ductal breast carcinomas treated by neoadjuvant chemotherapy. Int J Oncol 2002; 20: 791-796.
Petit T, Wilt M, Velten M, et al. Comparative value of tumour grade, hormonal receptors, Ki-67, HER-2 and topoisomearase II alpha status as predictive markers in breast cancer patients treated with neoadjuvant anthracycline-based chemotherapy. Eur J Cancer 2004; 40: 205-211.
Daveau C, Baulies S, Lalloum M, et al. Histological grade concordance between diagnostic core biopsy and corresponding surgical specimen in HR-positive/HER2-negative breast carcinoma. Br J Cancer 2014; 110: 2195-2200.
Lorgis V, Algros MP, Villanueva C, et al. Discordance in early breast cancer for tumour grade, estrogen receptor, progesteron receptors and human epidermal receptor-2 status between core needle biopsy and surgical excisional primary tumour. Breast 2011; 20: 284-287.
Ough M, Velasco J, Hieken TJ. A comparative analysis of core needle biopsy and final excision for breast cancer: histology and marker expression. Am J Surg 2011; 201: 692-694.
Ozdemir A, Voyvoda NK, Gultekin S, et al. Can core biopsy be used instead of surgical biopsy in the diagnosis and prognostic factor analysis of breast carcinoma? Clin Breast Cancer 2007; 7: 791-795.
Gwet KL. Handbook of Inter-Rater Reliability: The Definitive Guide to Measuring the Extent of Agreement Among Multiple Raters. 3rd ed. Advanced Analytics, LLC, Gaithersburg, MD 2012.
Measurement Systems Analysis: Reference Manual. 4th ed. AIAG-Work Group, Daimler Chrysler Corporation, Ford Motor Company, General Motors Corporation, 2010.
Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology 1991; 19: 403-410.
Anderson TJ, Alexander FE, Lamb J, et al. Pathology characteristics that optimize outcome prediction of a breast screening trial. Br J Cancer 2000; 83: 487-492.
Frkovic-Grazio S, Bracko M. Long term prognostic value of Nottingham histological grade and its components in early (pT1N0M0) breast carcinoma. J Clin Pathol 2002; 55: 88-92.
Focke CM, Decker T, van Diest J. The reliability of histological grade in breast cancer core needle biopsies depends on biopsy size: a comparative study with subsequent surgical excisions. Histopathology 2016; 69: 1047-1054.
Rakha EA, Reis-Filho JS, Baehner F, et al. Breast cancer prognostic classification in the molecular era: the role of histological grade. Breast Cancer Res 2010, 12: 207.
Reinert T, de Souza AB, Sartori GP, et al. Highlights of the 17th St Gallen International Breast Cancer Conference 2021: customising local and systemic therapies. Ecancermedicalscience 2021; 15: 1236.
Andrade VP, Gobbi H. Accuracy of typing and grading invasive mammary carcinomas on core needle biopsy compared with the excisional specimen. Virchows Arch 2004; 445: 597-602.
O’Shea AM, Rakha EA, Hodi Z, et al. Histological grade of invasive carcinoma of the breast assessed on needle core biopsy – modifications to mitotic count assessment to improve agreement with surgical specimens. Histopathology 2011; 59: 543-548.
Knuttel FM, Menezes GLG, van Diest PJ, et al. Meta-analysis of the concordance of histological grade of breast cancer between core needle biopsy and surgical excision specimen. Br J Surg 2016; 103: 644-655.
Harris GC, Denley HE, Pinder SE, et al. Correlation of histologic prognostic factors in core biopsies and therapeutic excisions of invasive breast carcinoma. Am J Surg Pathol 2003; 27: 1115.
Shannon J, Douglas-Jones AG, Dallimore NS. Conversion to core biopsy in preoperative diagnosis of breast lesions: is it justified by results? J Clin Pathol 2001; 54: 762-765.
Burge CN, Chang HR, Apple SK. Do the histologic features and results of breast cancer biomarker studies differ between core biopsy and surgical excision specimens? Breast 2006; 15: 167-172.
Park SY, Kim KS, Lee TG, et al. The accuracy of preoperative core biopsy in determining histologic grade, hormone receptors, and human epidermal growth factor receptor 2 status in invasive breast cancer. Am J Surg 2009; 197: 266-269.
Waaijer L, Willems SM, Verkooijen HM, et al. Impact of preoperative evaluation of tumour grade by core needle biopsy on clinical risk assessment and patient selection for adjuvant systemic treatment in breast cancer. Br J Surg 2015; 102: 1048-1055.
Marszałek A, Kubicka A, Jagiełło I, Malicka-Durczak A. Potential impact of HercepTest™ mAb PharmDx (Dako Omnis) (ge001) in breast cancer diagnosis. Pol J Pathol 2023; 74: 82-88.
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.