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Accuracy of typing and grading invasive mammary carcinomas on core needle biopsy compared with the excisional specimen

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Abstract

Introduction

Breast core needle biopsy (CNB) allows evaluation of histological, prognostic, and predictive factors in invasive mammary carcinomas (IMC). We tested the CNB accuracy on typing and grading of invasive breast carcinomas.

Materials and methods

A histological review of 120 CNBs and their related surgical specimens was carried out in a double-blind fashion. Tumor type and grade were assigned according to the World Health Organization classification and the Nottingham grading system.

Results

The sum of CNB fragment lengths varied from 4 mm to 38 mm (mean 16.7 mm), and tumor sample size varied from 1 mm to 26 mm (mean 11.1 mm). Histological type matched surgical specimen evaluation in 80 of 120 cases (66.6%). Of the cases, 17 (14.2%) were changed to a different prognostic category. Histological grade comparison was accurate in 56 of 95 cases (59.0%, kappa=0.35). Histological grade components (tubule formation, nuclear grade, and mitotic index) agreed, respectively, in 54.7%, 58.9%, and 62.1% (kappa index 0.30, 0.36, and 0.28).

Discussion

Typing IMC on CNB can be routinely assessed based on good correlation with surgical specimens, especially considering prognostic categories for IMC. Grading IMC based on CNB is not as accurate, and its evaluation should be delayed until the surgical specimen examination. Tumor heterogeneity seems to be the most important factor for disagreement.

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Acknowledgements

Supported by grants from Fundação de Amparo à Pesquisa de Minas Gerais (CDS-560/01) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (520117/00–0), Brazil. We are thankful to Ms. Sandra J. Olson, Vanderbilt University, USA, for revising the English manuscript.

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Authors and Affiliations

  1. Departamento de Anatomia Patológica, Faculdade de Medicina da UFMG, Belo Horizonte, Minas Gerais, Brazil

    Victor Piana de Andrade & Helenice Gobbi

  2. FLEURY—Centro de Medicina Diagnóstica, Av. General Waldomiro de Lima 508, Jabaquara-CEP 04344-070, São Paulo, Brazil

    Victor Piana de Andrade

Authors
  1. Victor Piana de Andrade
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  2. Helenice Gobbi
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Correspondence to Victor Piana de Andrade.

Additional information

This paper was presented as a poster presentation during the 24th International Congress of the International Academy of Pathology, Amsterdam, Netherlands, 5–11 October 2002, and the abstract was published in Histopathology 2002; 41[Suppl 4]:74–75.

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de Andrade, V.P., Gobbi, H. Accuracy of typing and grading invasive mammary carcinomas on core needle biopsy compared with the excisional specimen. Virchows Arch 445, 597–602 (2004). https://doi.org/10.1007/s00428-004-1110-5

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  • DOI: https://doi.org/10.1007/s00428-004-1110-5

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