Boba Marek, Kołtun Urszula, Bobek-Billewicz Barbara, Chmielik Ewa, Eksner Bartosz, Olejnik Tomasz
Department of Diagnostic Imaging, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland.
Pol J Radiol. 2011 Jan;76(1):25-9.
Breast cancer is the most common malignant neoplasm and the most common cause of death among women. The core needle biopsy is becoming a universal practice in diagnosing breast lesions suspected of malignancy. Unfortunately, breast core needle biopsies also bear the risk of having false-negative results.
MATERIAL/METHODS: 988 core needle breast biopsies were performed at the Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, between 01 March 2006 and 29 February 2008. Malignant lesions were diagnosed in 426/988 (43.12%) cases, atypical hyperplasia in 69/988 (6.98%), and benign lesions in 493/988 (49.90%) cases.
Twenty-two out of 988 biopsies (2.23%) were found to be false negative. Histopathological assessment of tissue specimens was repeated in these cases. In 14/22 (64%) cases, the previous diagnosis of a benign lesion was changed. In 8/22 (36%) cases, the diagnosis of a benign lesion was confirmed. False-negative rate was calculated at 2.2%. The rate of false-negative diagnoses resulting from a radiological mistake was estimated at 36%. The rate of false-negative diagnoses, resulting from histopathological assessment, was 64%. False-negative results caused by a radiological error comprised 1.5% of all histopathologically diagnosed cancers and atypias (sensitivity of 98.5%). There were no false-positive results in our material - the specificity of the method was 100%.
Histopathological interpretation is a substantial cause of false-negative results of breast core needle biopsy. Thus, in case of a radiological-histopathological divergence, histopathological analysis of biopsy specimens should be repeated. The main radiological causes of false-negative results of breast core needle biopsy are as follows: sampling from an inappropriate site and histopathological non-homogeneity of cancer infiltration.
乳腺癌是女性中最常见的恶性肿瘤和最常见的死亡原因。在诊断疑似恶性的乳腺病变时，粗针活检正成为一种普遍的做法。不幸的是，乳腺粗针活检也存在假阴性结果的风险。
材料/方法：2006年3月1日至2008年2月29日期间，在玛丽亚·斯克洛多夫斯卡-居里纪念癌症中心和格利维采分所肿瘤研究所进行了988例乳腺粗针活检。988例中诊断为恶性病变的有426例（43.12%），非典型增生69例（6.98%），良性病变493例（49.90%）。
988例活检中有22例（2.23%）为假阴性。对这些病例的组织标本进行了重复组织病理学评估。其中14例（64%）之前诊断的良性病变被改变。8例（36%）中良性病变的诊断得到确认。假阴性率计算为2.2%。因放射学错误导致的假阴性诊断率估计为36%。因组织病理学评估导致的假阴性诊断率为64%。放射学错误导致的假阴性结果占所有经组织病理学诊断的癌症和非典型增生的1.5%（敏感性为98.5%）。我们的材料中没有假阳性结果——该方法的特异性为100%。
组织病理学解释是乳腺粗针活检假阴性结果的一个重要原因。因此，在放射学-组织病理学出现分歧的情况下，应重复对活检标本进行组织病理学分析。乳腺粗针活检假阴性结果的主要放射学原因如下：从不当部位取材以及癌症浸润的组织病理学不均匀性。
