Tseng H S, Chen Y L, Chen S T, Wu Y C, Kuo S J, Chen L S, Wu H K, Chen D R
Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan.
Eur J Surg Oncol. 2009 Jan;35(1):21-4. doi: 10.1016/j.ejso.2008.06.004. Epub 2008 Jul 21.
The purpose of this study was to determine the accuracy of core needle biopsy (CNB) diagnoses of papillary breast lesions, and to identify the risk factors and histologic features, compared with excisional biopsy (EB).
We retrospectively reviewed 1,682 sonographically guided core needle biopsies performed at one single medical center from January 2001 through December 2005, and identified 41 papillary lesions. Surgical correlation was available for 35 cases, 2 cases were loss follow-up and 4 cases diagnosed as papilloma by core needle biopsy were followed up with imaging for at least 24 months.
The pathologic diagnoses for the 35 papillary lesions obtained at core biopsy were benign in 24 cases, atypical in 7, and malignant in 4. Of those diagnosed as benign lesions at CNB, 7/24 turned out to be malignant. In the hyperplasia group, 5/7 were malignant. The total upgrade rate was 39%. The positive predict value was 100% and negative predict value was 61%.
All papillary lesions of the breast diagnosed by CNB should be excised because a substantial number of lesions were upgraded of diagnoses at excision.
本研究的目的是确定粗针穿刺活检（CNB）诊断乳腺乳头状病变的准确性，并与切除活检（EB）相比，确定其危险因素和组织学特征。
我们回顾性分析了2001年1月至2005年12月在单一医疗中心进行的1682例超声引导下粗针穿刺活检，确定了41例乳头状病变。35例有手术相关性，2例失访，4例粗针穿刺活检诊断为乳头状瘤的患者接受了至少24个月的影像学随访。
粗针活检获得的35例乳头状病变的病理诊断中，24例为良性，7例为非典型性，4例为恶性。在CNB诊断为良性病变的患者中，7/24最终被证实为恶性。在增生组中，5/7为恶性。总体升级率为39%。阳性预测值为100%，阴性预测值为61%。
所有经CNB诊断的乳腺乳头状病变均应切除，因为大量病变在切除时诊断升级。
