scholarly journals Percutaneous core biopsy of palpable breast lesions: accuracy of frozen section histopathological exam in the diagnosis of breast cancer

2014 ◽  
Vol 41 (1) ◽  
pp. 07-10
Author(s):  
Roberto Luiz Carvalhosa Dos Santos ◽  
Ricardo Bassil Lasmar ◽  
Tereza Maria Pereira Fontes ◽  
Rachel De Carvalho Silveira De Paula Fonseca ◽  
Paula De Azevedo Brant Saldanha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Predictive Value ◽  
Core Biopsy ◽  
Frozen Section ◽  
False Negative ◽  
Breast Lesions ◽  
Needle Core Biopsy ◽  
Excellent Correlation ◽  
Percutaneous Core Needle Biopsy ◽  
Palpable Breast

OBJECTIVE: to evaluate the accuracy of frozen section histopathology from fragments of tissue obtained by percutaneous core needle biopsy of palpable tumors in the diagnosis of breast cancer. METHODS: a cohort study was performed on 57 patients with palpable tumors and suspected breast cancer undergoing percutaneous thick needle core biopsy. The fragments were analyzed by the same pathologist. RESULTS: frozen section diagnosed 16 benign cases (28.6%) and 40 malignant (71.4%), whereas paraffin showed that 15 were benign (26.8%) and 41 malignant (73.2%). Histopathological examinations were concordant in 55 cases and there was one false-negative (6.2%). Statistics rates were: negative predictive value of 93.8%, positive predictive value of 100%, no false-positive (0%), one false negative (6.2%), specificity of 100%, sensitivity of 97 6%; observed agreement = 98.2%; expected agreement = 59.9%, Kappa = 0.955 [ 95% CI = 0.925-0.974, p < 0.01 ]. CONCLUSIONS: frozen section histopathological findings showed excellent correlation with the findings by the technique in paraffin in the fragments of palpable breast tumors obtained by thick needle percutaneous core biopsy (98.2% accuracy). Therefore, in these patients, it was possible to anticipate the diagnosis, staging and the breast cancer treatment planning.

Predictive Value of Breast Lesions of “Uncertain Malignant Potential” and “Suspicious for Malignancy” Determined by Needle Core Biopsy

2006 ◽  
Vol 14 (2) ◽  
pp. 704-711 ◽  
Author(s):  
Mary F. Dillon ◽  
Enda W. McDermott ◽  
Arnold D. Hill ◽  
Ann O’Doherty ◽  
Niall O’Higgins ◽  
...  
Keyword(s):  
Predictive Value ◽  
Core Biopsy ◽  
Malignant Potential ◽  
Breast Lesions ◽  
Needle Core Biopsy ◽  
Uncertain Malignant Potential

scholarly journals Social Aspects of Diagnosis and Treatment of Non-palpable Breast Lesions. Important Factor affecting Quality of Life in Cancer Patients undergoing Surgery

2021 ◽  
Vol 12 (2) ◽  
pp. 25-30
Author(s):  
M. Bakos ◽  
T. Jankovic ◽  
V. Krcmery ◽  
M. Dubovcova
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
False Negative ◽  
Positive Margin ◽  
Social Aspect ◽  
Breast Lesions ◽  
Non Palpable Lesions ◽  
Palpable Breast ◽  
Sentinel Biopsy

Introduction: The social aspect of breast cancer presents a serious problem all the time. Quality of women´s life after surgery must be compared to life before it. Breast cancer treatments today are likely to cause less physical deformity from surgery than two decades ago but are more complex and extend over a longer period of time. Non-palpable breast lesions are findings with non-biologically specified importance, which can be responsible for development of cancer. The authors present the diagnosis and the results of the treatment of patients with non-palpable breast lesions. They were hospitalized at the Department of Surgery in Nitra from Jan uary 2014 untilJuly 2017 and we used the SNOLLmethod or wire guided excision under ultrasound control or digital stereotaxic. Results: From January 2014 until July 2017 there were 122 patients diagnosed with non-palpable breast lesions at the Department of Surgery at our hospital. 76 (62.3%) of these patients were diagnosed with carcinoma. Wire Guided Localization was performed in 99 (81.1%) patients; sentinel node was found in 41 (33.6%) patients using the SNOLL method. From all the patients a reoperation was conducted in 4 cases (3.3%) for close or positive margin status and in 3 cases (2.5%) for false negative perioperative sentinel biopsy.                                                                Conclusion: The technique combining 99mTc-MAA (albuminmacro aggregate marked by 99Technecium) and nanocoloid is a reliable localization method for non-palpable lesions and sentinel nodes. SNOLL is a practical and oncological safe technique of excision of a subclinical lesion in combination with sentinel biopsy. This technique brings new visions for the future, especially for quality of life after surgery, changes in body image and sexuality.

Ultrasound-guided core needle biopsy of non-palpable breast lesions: a prospective analysis in 204 cases

2005 ◽  
Vol 46 (7) ◽  
pp. 690-695 ◽  
Author(s):  
A. Vega BolÍvar ◽  
P. Alonso-Bartolomé ◽  
E. Ortega GarcÍa ◽  
F. Garijo Ayensa
Keyword(s):  
Core Needle Biopsy ◽  
Predictive Value ◽  
Needle Biopsy ◽  
Core Biopsy ◽  
Breast Biopsy ◽  
Diagnostic Yield ◽  
Breast Lesions ◽  
Core Needle ◽  
Palpable Breast

Purpose: To assess the diagnostic value of ultrasound (US)-guided 14 G core needle breast biopsy in non-palpable suspicious breast lesions. Material and Methods: From August 1997 to April 2001, 198 patients with 204 suspicious non-palpable breast lesions underwent US-guided large core needle biopsy. Biopsies were performed with a free-hand technique using US equipment with a 7.5 MHz linear-array transducer; a minimum of three cores were obtained from each lesion. Pathological findings in US-guided core biopsy were correlated to findings in subsequent surgery or long-term (more than 2 years) imaging follow-up. Results: Among the 204 non-palpable breast lesions for which histopathological findings were obtained by US-guided core biopsy, 118 were malignant (114 carcinoma, 2 metastasis, 1 lymphoma, and 1 malignant phyllodes tumor) and 86 were benign (4 carcinoma and 82 benign lesions confirmed at surgery or after at least 2 years of follow-up). Sensitivity, specificity, positive predictive value, and negative predictive value for diagnosis of malignancy in our series were 97%, 100%, 100%, and 95%, respectively. Diagnostic yield with 1, 2, 3, and 4 specimens per lesion was 73.5%, 88%, 94%, and 97.5%, respectively. Conclusion: US-guided core needle biopsy is a sensitive percutaneous biopsy method for diagnosing non-palpable breast lesions. To achieve a high diagnostic yield, a minimum number of three cores per lesion is advisable.

scholarly journals False-Negative Frozen Section of Sentinel Nodes in Early Breast Cancer Patients

2021 ◽  
Author(s):  
Zhu-Jun Loh ◽  
Kuo-Ting Lee ◽  
Ya-Ping Chen ◽  
Yao-Lung Kuo ◽  
Wei-Pang Chung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Frozen Section ◽  
False Negative ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Frozen Sections ◽  
Sentinel Nodes ◽  
Tumor Emboli

Abstract Background: Sentinel lymph node biopsy (SLNB) is the standard approach of the axillary region for early breast cancer patients with clinically negative nodes. The present study investigated patients with false-negative sentinel nodes of intraoperative frozen section (FNSNs) in real-world data.Methods: A case–control study with a 1:3 ratio was conducted. FNSN was diagnosed when sentinel nodes (SNs) are negative in frozen sections but positive for metastasis in formalin-fixed paraffin-embedded (FFPE) sections. The control was defined as having no metastasis of SNs in both frozen and FFPE sections.Results: A total of 20 FNSN cases and 60 matched controls were enrolled from 333 SLNB patients between April 1, 2005, and November 31, 2009. The demographics and intrinsic subtypes of breast cancer were similar between FNSN and controls. The FNSN patients had larger tumor sizes in preoperative mammography (P = 0.033) and more lymphatic tumor emboli in core biopsy (P < 0.001). Four FNSN patients had metastasis in the non-relevant SNs. Another 16 FNSN patients had benign lymphoid hyperplasia of SNs in frozen sections and metastasis in the same SNs from the FFPE sections. Micrometastasis was detected in seven of 16 patients, and metastases in non-relevant SNs were recognized in two patients. All FNSN patients received a second operation with axillary lymph node dissection (ALND). After a median follow-up of 143 months, no FNSN patients developed recurrence of breast cancer. The disease-free survival, disease-specific survival, and overall survival in FNSN were not inferior to the controls.Conclusions: The patients with a larger tumor size and more lymphatic tumor emboli have a higher incidence of FNSN. However, outcomes of FNSN patients after completing ALND were noninferior to those without metastasis in SNs. ALND provides a correct diagnosis of patients with metastasis in non-sentinel axillary lymph nodes.

scholarly journals Cytokeratin on Frozen Sections of Sentinel Node May Spare Breast Cancer Patients Secondary Axillary Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Elisabeth Specht Stovgaard ◽  
Tove Filtenborg Tvedskov ◽  
Anne Vibeke Lænkholm ◽  
Eva Balslev
Keyword(s):  
Breast Cancer ◽  
Sentinel Node ◽  
Predictive Value ◽  
Frozen Section ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Frozen Sections ◽  
Paraffin Sections ◽  
Significant Difference ◽  
Diagnostic Values

Background. The feasibility and accuracy of immunohistochemistry (IHC) on frozen sections, when assessing sentinel node (SN) status intraoperatively in breast cancer, is a matter of continuing discussion. In this study, we compared a center using IHC on frozen section with a center not using this method with focus on intraoperative diagnostic values. Material and Methods. Results from 336 patients from the centre using IHC intraoperatively were compared with 343 patients from the center not using IHC on frozen section. Final evaluation on paraffin sections with haematoxylin-eosin (HE) staining supplemented with cytokeratin staining was used as gold standard. Results. Significantly more SN with isolated tumor cells (ITCs) and micrometastases (MICs) were found intraoperatively when using IHC on frozen sections. There was no significant difference in the number of macrometastases (MACs) found intraoperatively. IHC increased the sensitivity, the negative predictive value, and the accuracy of the intraoperative evaluation of SN without decreasing the specificity and positive predictive value of SN evaluation. Conclusions. IHC on frozen section leads to the detection of more ITC and MIC intraoperatively. As axillary lymph node dissection (ALND) is performed routinely in some countries when ITC and MIC are found in the SN, IHC on frozen section provides valuable information that can lead to fewer secondary ALNDs.

SP3, a reliable alternative to HercepTest in determining HER-2/neu status in breast cancer patients

2013 ◽  
Vol 66 (5) ◽  
pp. 409-414 ◽  
Author(s):  
Timothy Michael D'Alfonso ◽  
Yi-Fang Liu ◽  
Zhengming Chen ◽  
Ying-Bei Chen ◽  
Ashley Cimino-Mathews ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Core Biopsy ◽  
In Situ Hybridisation ◽  
Excisional Biopsy ◽  
Needle Core Biopsy ◽  
Breast Cancer Patients ◽  
Biopsy Specimens ◽  
Her 2

Accurate assessment of HER-2/neu gene status in breast cancer patients has important prognostic and therapeutic implications. Overexpression/gene amplification of HER-2 is associated with a more aggressive clinical course and eligibility for targeted therapy with trastuzumab. A variety of immunohistochemical (IHC) antibodies and in situ hybridisation (ISH) methods have been employed to assess HER-2 status. SP3 is a rabbit monoclonal antibody that has been shown to have a high level of agreement with other anti-HER-2 antibodies and ISH methods. We assessed HER-2 status by SP3 and HercepTest IHC stains and by fluorescence in situ hybridisation (FISH) on invasive breast carcinomas from paired needle core biopsy and excisional biopsy specimens from 100 patients. We compared the two antibodies with respect to concordance rates with FISH, concordance rates between samples of the same tumour, and sensitivity and specificity using FISH as the reference test. Concordance between SP3 and FISH in needle core biopsy and excisional biopsy specimens was 96% (95% CI 91.9% to 99.7%) (κ=0.89 (95% CI 0.73 to 1.00)) and 97% (95% CI 90.3% to 99.3%) (κ=0.84 (95% CI 0.66 to 1.00)), respectively. Sensitivity and specificity of SP3 for detecting HER-2 overexpression/gene amplification were 78.3% and 100%, respectively, in needle core biopsy and excisional biopsy specimens. Concordance between SP3 results assessed on the needle core biopsy and excisional biopsy was 89% (95% CI 81.2% to 94.4%) (κ=0.62 (95% CI 0.42 to 0.82)). Concordance between SP3 and HercepTest antibodies, after excluding 2+ cases, was 97.6% (95% CI 94.0% to 99.3%) (κ=0.88 (95% CI 0.77 to 1.00)). SP3 is a reliable alternative to HercepTest in evaluating HER-2 status in breast cancer patients. Like other anti-HER-2 antibodies, SP3 may serve as a diagnostic tool in breast pathology and has potential utility as an IHC biomarker in non-mammary malignancies.

Sign in / Sign up

Export Citation Format

Share Document