Frankel Patrícia Pontes, Esteves Viviane Fernandes, Thuler Luiz Claudio Santos, Vieira Roberto José da Silva
Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
Rev Bras Ginecol Obstet. 2011 Mar;33(3):139-43. doi: 10.1590/s0100-72032011000300007.
to determine the accuracy of fine-needle aspiration biopsy (FNAB) and of core-needle biopsy (CNB) in diagnosing breast lumps and breast cancer.
this was a cross-sectional, retrospective and descriptive study based on the review of medical records. FNAB and CNB were carried out sequentially according to the routine of the Mastology Service. Both percutaneous procedures were applied to 233 patients during the period from March 2005 to February 2007. Women aged 18 years or more with changes in the clinical and/or image examination of the breast or a family history of breast and/or ovarian cancer were included. FNAB and CNB were carried out according to the technical recommendations of the National Institute of Cancer. The percentage of agreement, Cohen's Kappa coefficient, sensitivity, specificity, positive and negative predictive values and the accuracy of FNAB and CNB were calculated, considering the surgical biopsy as the gold standard.
the average age of the patients was 49.0 years (±12.7) and the tumors measured 26.9 mm on average (±23.1), being larger than 20 mm in 47.2% of cases. Sensitivity, specificity, positive and negative predictive values and accuracy were higher for CNB than for FNAB, regardless of the size of the breast lesion. The diagnostic accuracy was 97.5% for CNB and 77.5% for FNAB.
although the CNB showed higher rates of sensitivity, specificity, positive predictive value, negative predictive value and accuracy than FNAB for palpable and non-palpable breast lumps, the method remains useful for the minimally invasive diagnosis of mammary lesions, especially when its results are analyzed together with the clinical and imaging examination.
确定细针穿刺活检（FNAB）和粗针穿刺活检（CNB）在诊断乳腺肿块和乳腺癌方面的准确性。
这是一项基于病历回顾的横断面、回顾性描述性研究。根据乳腺科服务常规依次进行FNAB和CNB。在2005年3月至2007年2月期间，对233例患者实施了这两种经皮穿刺操作。纳入年龄在18岁及以上、乳腺临床和/或影像检查有变化或有乳腺癌和/或卵巢癌家族史的女性。FNAB和CNB均按照国家癌症研究所的技术建议进行。以手术活检作为金标准，计算FNAB和CNB的一致性百分比、科恩卡方系数、敏感性、特异性、阳性和阴性预测值以及准确性。
患者的平均年龄为49.0岁（±12.7），肿瘤平均大小为26.9 mm（±23.1），47.2%的病例肿瘤大于20 mm。无论乳腺病变大小如何，CNB的敏感性、特异性、阳性和阴性预测值及准确性均高于FNAB。CNB的诊断准确性为97.5%，FNAB为77.5%。
尽管对于可触及和不可触及的乳腺肿块，CNB在敏感性、特异性、阳性预测值、阴性预测值和准确性方面的比率均高于FNAB，但该方法对于乳腺病变的微创诊断仍然有用，尤其是当将其结果与临床和影像检查结果一起分析时。
