Accuracy and Cost-Effectiveness of Core Needle Biopsy in the Evaluation of Suspected Lymphoma: A Study of 101 Cases

2007 ◽  
Vol 131 (7) ◽  
pp. 1033-1039
Author(s):  
Whitney A. Lachar ◽  
Imran Shahab ◽  
A. Joe Saad
Keyword(s):  
Cost Effectiveness ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Cost Savings ◽  
Diagnostic Technique ◽  
Diagnostic Features ◽  
Core Needle ◽  
Architectural Framework ◽  
Molecular Aspects ◽  
Ancillary Studies

Abstract Context.—Lymphomas have traditionally been diagnosed on excisional biopsies of lymph nodes in order to evaluate tissue architecture and cytomorphology. Recent lymphoma classification schemes emphasize immunophenotypic, genetic, and molecular aspects in addition to morphology as diagnostic features. Core needle biopsies are increasingly being used to obtain tissue for diagnosis in patients with lymphadenopathy and a clinical suspicion of lymphoma. These procedures are rapid, minimally invasive, well tolerated, and may provide some architectural framework (unlike fine-needle aspirations), as well as material for ancillary studies. Objective.—To explore the accuracy, utility, and cost-effectiveness of this technique. Design.—Core needle biopsies of 101 consecutive patients from 2 large community hospitals who were suspected of having primary or recurrent lymphomas were retrospectively reviewed. All patients had hematoxylin-eosin–stained sections of needle cores. Specimens morphologically suspicious for lymphoma were subjected to ancillary studies, including immunohistochemistry, flow cytometry, and/or molecular studies. Core needle biopsy diagnoses were correlated with subsequent excisional biopsies, if performed. Results.—Core needle biopsies established a definitive pathologic diagnosis for the vast majority of cases. A diagnosis was considered sufficient to begin treatment for primary and recurrent lymphomas in most cases. Compared with an open biopsy, there is a cost savings of greater than 75%. Conclusion.—The accuracy of this technique, along with the cost savings and decreased morbidity, suggest that this method may be used safely and reliably as a first-line diagnostic technique.

scholarly journals Contrast-Enhanced Ultrasound Improves the Pathological Outcomes of US-Guided Core Needle Biopsy That Targets the Viable Area of Anterior Mediastinal Masses

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Jian-hua Zhou ◽  
Hong-bo Shan ◽  
Wei Ou ◽  
Yun-xian Mo ◽  
Jin Xiang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Contrast Enhanced Ultrasound ◽  
Ultrasound Guided ◽  
Core Needle ◽  
Mediastinal Masses ◽  
Contrast Enhanced ◽  
Ancillary Studies

Based on the option that ultrasound-guided core needle biopsy (US-CNB) of the enhanced portion of anterior mediastinal masses (AMMs) identified by contrast-enhanced ultrasound (CEUS) would harvest viable tissue and benefit the histological diagnoses, a retrospective study was performed to elucidate the correlation between the prebiopsy CEUS and diagnostic yield of AMMs and found that CEUS potentially improved the diagnostic yield of AMMs compared with conventional US with a significant increase in the cellularity of samples. Furthermore, the marginal blood flow signals and absence of necrosis can predict the diagnostic yield of AMM. It was concluded that US-CNB of the viable part of AMMs, as verified by CEUS, was able to harvest sufficient tissue with more cellularity that could be used for ancillary studies and improve the diagnostic yield. And CEUS was recommended to those patients with AMMs undergoing repeated US-CNB, with the absence of marginal blood signals or presence of necrosis.

scholarly journals Costs of Diagnosing Breast-Related Conditions at a Large, Public Hospital in a Middle-Income Country Without Population-Level Screening

2017 ◽  
Vol 3 (2_suppl) ◽  
pp. 21s-21s
Author(s):  
Naomi Lince-Deroche ◽  
Craig Van Rensburg ◽  
Cindy Firnhaber ◽  
Carol Benn ◽  
Grace Rubin ◽  
...  
Keyword(s):  
Outpatient Clinic ◽  
Core Needle Biopsy ◽  
Average Cost ◽  
Needle Biopsy ◽  
Cost Savings ◽  
Middle Income Country ◽  
Income Country ◽  
Middle Income ◽  
Core Needle ◽  
Mammography Use

Abstract 42 Background: Literature regarding the costs and cost-effectiveness of diagnosing breast disease globally, including cancer, has focused on mammographic screening in high-income settings. South Africa, a middle-income country, is currently crafting its first national breast cancer policy, and information on costs and best practices for national imaging services in low- and middle-income settings is required. We undertook this work to estimate the average cost per procedure and per patient for diagnosis of breast conditions by using a large, public outpatient clinic in Johannesburg as well as to explore potential cost savings through rationing mammography for diagnosis. Methods: Results of a retrospective clinical cohort study conducted at an outpatient clinic in 2013 and 2014 were used to establish a 12-month population of clinic patients and diagnostic service statistics. We used microcosting to estimate the average cost for each diagnostic procedure from the health service perspective. An Excel-based model and scenario analysis were used to explore changes in total and per patient costs when mammography use was incrementally reduced by shifting patients to ultrasound-based services. Results: We estimated that 3,867 individuals attended the clinic over 12 months. The average cost per patient for initial consultation and/or exam was $10.14 (2015 USD). Mammography was more costly than ultrasound at $59.96 and $21.11, respectively. Procedures for pathology were the most costly diagnostic (stereotactic core needle biopsy, $330.05; ultrasound-guided core needle biopsy, $279.42; fine needle aspiration, $101.00) because of substantial laboratory charges. The average cost per patient seen was $115.96. Hypothetically, replacing mammography with ultrasound resulted in minimal decreases in the average cost per patient as a result of the high cost of the mammogram machine. Cost savings at the facility level may be achieved when mammography use is eliminated entirely. Conclusion: Per patient mammography costs are largely dependent on economies of scale. Because ultrasound can be considered as an alternative for many women without compromising imaging in nonoccult disease, diagnostic mammography should be offered in centralized locations for maximum efficiency gains. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Naomi Lince-Deroche No relationship to disclose Craig Van Rensburg No relationship to disclose Cindy Firnhaber Research Funding: Merck (Inst) Carol Benn No relationship to disclose Grace Rubin No relationship to disclose Pam Michelow No relationship to disclose Sarah Rayne Travel, Accommodations, Expenses: Novartis

Cost-effectiveness of stereotactic core needle biopsy: analysis by means of mammographic findings.

Radiology ◽  
1997 ◽  
Vol 202 (3) ◽  
pp. 849-854 ◽  
Author(s):  
C H Lee ◽  
T K Egglin ◽  
L Philpotts ◽  
M B Mainiero ◽  
I Tocino
Keyword(s):  
Cost Effectiveness ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Core Needle ◽  
Stereotactic Core Needle Biopsy ◽  
Stereotactic Core

scholarly journals Hematologic Malignancies of the Breast: A Contemporary Series Investigating Incidence, Presentation, Accuracy of Diagnosis on Core Needle Biopsy, and Hormone Receptor Expression

2019 ◽  
Vol 13 ◽  
pp. 117822341983098
Author(s):  
Marie-Christine Guilbert ◽  
Jason L Hornick ◽  
Sona A Chikarmane ◽  
Susan C Lester
Keyword(s):  
Estrogen Receptor ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Core Biopsy ◽  
Hematologic Malignancy ◽  
Hematologic Malignancies ◽  
Receptor Expression ◽  
Diagnostic Features ◽  
Core Needle ◽  
The Core

Background: Distinguishing breast hematologic malignancies in core needle biopsies from other entities can be challenging. Misclassification as a breast carcinoma could result in inappropriate treatment. The aim of this study was to characterize the types, incidence, and helpful diagnostic features of hematologic malignancies of the breast. Design: All hematologic malignancies of the breast diagnosed at our institution from 2004 to 2017 were identified. Clinical notes, imaging, and slides were reviewed. Immunohistochemical analysis of estrogen receptor α (ERα), estrogen receptor β (ERβ), and androgen receptor (AR) was performed when tissue was available. Results: In all, 43 hematologic malignancies from biopsies of 37 women and 6 men were identified. Core needle biopsies (35 or 81%) were more common than excisions (8 or 19%). For 14 patients (40%), the core biopsy was the first diagnosis of a hematologic malignancy. Diagnoses included 37 lymphomas (7 primary), 4 leukemias, and 2 myelomas. There was 1 misdiagnosis of carcinoma. Low positivity for hormone receptors was observed in a minority of lymphomas. A definitive diagnosis of hematologic malignancy was made in 31 (89%) of the core needle biopsies. Only 3 patients undergoing core biopsy required excision for diagnosis. Conclusions: Most of the hematologic malignancies of the breast are currently diagnosed on core needle biopsy and 40% of patients do not have a prior history. To avoid errors, pathologists need to be aware of diagnostic features and morphologic mimics. A hematologic malignancy should be considered if tumor cells are discohesive, carcinoma in situ is absent, and hormone expression is low or absent.

Diagnosis of Lymphoma Using Fine-Needle Aspiration Biopsy and Core-Needle Biopsy: A Single-Institution Experience

2019 ◽  
Vol 63 (3) ◽  
pp. 198-205
Author(s):  
Fatima-Zahra Jelloul ◽  
Maria Navarro ◽  
Pooja Navale ◽  
Tamla Hagan ◽  
Rubina S. Cocker ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Definitive Diagnosis ◽  
Single Institution ◽  
Core Needle ◽  
Fine Needle ◽  
Ancillary Studies

Objective: The objective is to study the efficacy of fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB) in the diagnosis of lymphoma in a single institution. Study Design: We retrospectively reviewed 635 FNAB/CNB cases performed in our institution to rule out lymphoma during a 4-year period and collected the relevant clinical and pathological information for statistical analysis. Results and Conclusions: This cohort comprised 275 males and 360 females, with a median age of 57 years. Among the 593 cases with adequate diagnostic materials for lymphoma work-up, 226 were positive for lymphoma, 286 were negative for lymphoma, and 81 were nondiagnostic. Each case had an FNAB, and 191 cases also underwent a CNB. The subclassification rate according to the WHO (2008) was 67% overall, 81% for the FNAB with CNB group, and 40% for the FNAB group. In the FNAB with CNB group, the subclassification rates for cases with and without a history of lymphoma were not significantly different. A definitive diagnosis of lymphoma relied on ancillary studies, but was not affected by location, or the needle gauge of CNB. Follow-up data revealed a high diagnostic accuracy of FNAB with CNB. In conclusion, the use of FNAB and CNB with ancillary studies is effective in providing a definitive diagnosis of lymphoma in our experience at the Northwell Health System.

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