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Accuracy of classification of invasive lobular carcinoma on needle core biopsy of the breast
  1. Kalnisha Naidoo1,
  2. Brooke Beardsley1,
  3. Pauline J Carder2,
  4. Rahul Deb3,
  5. David Fish4,
  6. Anne Girling5,
  7. Sally Hales6,
  8. Miles Howe7,
  9. Laura M Wastall8,
  10. Sally Lane8,
  11. Andrew H S Lee9,
  12. Marianna Philippidou1,
  13. Cecily Quinn10,
  14. Tim Stephenson11,
  15. Sarah E Pinder1
  1. 1Department of Research Oncology, King's College London, London, UK
  2. 2Department of Pathology, Bradford Hospitals NHS Trust, Bradford, UK
  3. 3Derby Teaching Hospitals NHS Foundation Trust, Derby, UK
  4. 4Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK
  5. 5Norfolk and Norwich University Hospital, Norwich, UK
  6. 6Countess of Chester Hospital NHS Foundation Trust, Chester, UK
  7. 7University Hospital of South Manchester, Manchester, UK
  8. 8Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK
  9. 9Histopathology Department, Nottingham University Hospitals, Nottingham, UK
  10. 10St Vincent's University Hospital, Dublin, Ireland
  11. 11Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  1. Correspondence to Professor SE Pinder, Division of Cancer Studies, King's College London, 3rd Floor, Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK; sarah.pinder{at}kcl.ac.uk

Abstract

Although the UK National Institute for Health and Care Excellence guidelines recommend that in patients with biopsy-proven invasive lobular carcinoma (ILC), preoperative MRI scan is considered, the accuracy of diagnosis of ILC in core biopsy of the breast has not been previously investigated. Eleven pathology laboratories from the UK and Ireland submitted data on 1112 cases interpreted as showing features of ILC, or mixed ILC and IDC/no special type (NST)/other tumour type, on needle core biopsy through retrieval of histology reports. Of the total 1112 cases, 844 were shown to be pure ILC on surgical excision, 154 were mixed ILC plus another type (invariably ductal/NST) and 113 were shown to be ductal/NST. Of those lesions categorised as pure ILC on core, 93% had an element of ILC correctly identified in the core biopsy sample and could be considered concordant. Of cores diagnosed as mixed ILC plus another type on core, complete agreement between core and excision was 46%, with 27% cases of pure ILC, whilst 26% non-concordant. These data indicate that there is not a large excess of expensive MRIs being performed as a result of miscategorisation histologically.

  • BREAST CANCER
  • BREAST PATHOLOGY
  • CLINICAL AUDIT

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