HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dillon, M F Articles by Hill, A D K Search for Related Content PubMed PubMed Citation Articles by Dillon, M F Articles by Hill, A D K Pubmed/NCBI databases Medline Plus Health Information Breast Cancer

Diagnostic accuracy of core biopsy for ductal carcinoma in situ and its implications for surgical practice

¹ Department of Surgery, St Vincent’s University Hospital, Dublin
² Department of Pathology, St Vincent’s University Hospital
³ Department of Radiology, St Vincent’s University Hospital

Correspondence to:
A D K Hill
Department of Surgery, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland; adkhill{at}rcsi.ie Background: Core biopsy is considered to be a highly accurate method of gaining a preoperative histological diagnosis of breast cancer. Ductal carcinoma in situ (DCIS) is often impalpable and is a more subtle form of breast cancer.

Aim: To investigate the accuracy of core biopsy in the diagnosis of cancer in patients with DCIS.

Methods: All patients who had invasive cancer (n = 959) or DCIS (n = 92) that was confirmed by excision between 1999 and 2004 were identified. The diagnostic methods, histology of the core biopsy specimen and excision histology were reviewed in detail.

Results: Core biopsy was attempted in 88% (81/92) of patients with DCIS and in 91% (874/959) of those with invasive disease. Of those patients who underwent core biopsy, a diagnosis of carcinoma on the initial core was made in 65% (53/81) of patients with DCIS compared with 92% (800/874) of patients with invasive disease (p<0.0001). Smaller lesion size (p = 0.005) and lower grade (p = 0.03) were associated with increased risk for a negative or non-diagnostic core in patients with DCIS. The nature of the mammographic lesion or the method of biopsy did not affect the probability of an accurate core biopsy. Patients who had a preoperative diagnosis of DCIS by core biopsy had a reoperation rate of 36% compared with 65% of those that did not have a preoperative diagnosis (p = 0.007).

Conclusion: Although core biopsies are highly accurate forms of obtaining a preoperative diagnosis in patients with invasive breast cancer, this is not the case in DCIS. As the number of surgical procedures can be reduced by core biopsy, it is still of considerable value in the management of DCIS.

Abbreviations: AIEP, atypical intraductal epithelial proliferation; DCIS, ductal carcinoma in situ

This article has been cited by other articles:

				E A Rakha and I O Ellis An overview of assessment of prognostic and predictive factors in breast cancer needle core biopsy specimens J. Clin. Pathol., December 1, 2007; 60(12): 1300 - 1306. [Abstract] [Full Text] [PDF]

				M. F. Dillon, E. W. Mc Dermott, A. O'Doherty, C. M. Quinn, A. D. Hill, and N. O'Higgins Factors Affecting Successful Breast Conservation for Ductal Carcinoma in Situ Ann. Surg. Oncol., May 1, 2007; 14(5): 1618 - 1628. [Abstract] [Full Text] [PDF]

				M. F. Dillon, E. W. McDermott, A. D. Hill, A. O'Doherty, N. O'Higgins, and C. M. Quinn Predictive Value of Breast Lesions of "Uncertain Malignant Potential" and "Suspicious for Malignancy" Determined by Needle Core Biopsy Ann. Surg. Oncol., February 1, 2007; 14(2): 704 - 711. [Abstract] [Full Text] [PDF]