Department of Histopathology, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK.
J Clin Pathol. 2012 Dec;65(12):1097-9. doi: 10.1136/jclinpath-2012-200968. Epub 2012 Aug 22.
It is a standard practice to examine multiple levels of needle core biopsies taken for mammographic calcification, but there is almost no evidence on the value of levels in core biopsies taken for other reasons. This study aimed to assess the value of levels for needle core biopsies taken for investigation of lesions other than calcification. A secondary aim was to assess interobserver agreement of diagnosis.
For each of the 375 breast core biopsies with three levels the first level was reviewed and a diagnosis made. Then levels 2 and 3 were reviewed and a final diagnosis was made.
The diagnosis after examining three levels was different from that in the initial level in 4 of 272 (1.5%, 95% CI 0.04% to 3%) core biopsies taken for reasons other than calcification and in 13 of 103 (13%, 95% CI 6% to 19%) biopsies taken for investigation of calcification. Interobserver agreement of the original diagnosis at the time of reporting and the final diagnosis at the review for this study was 96% (κ 0.947).
This study confirms the value of levels of biopsies taken to investigate mammographic calcification, but suggests that routine levels are of limited value for breast core biopsies taken for other reasons.
对因乳腺钙化而行的多针芯穿刺活检的多个层面进行检查是一种标准做法，但对于因其他原因而行的针芯穿刺活检的层面价值，几乎没有证据。本研究旨在评估对除钙化外其他原因行针芯穿刺活检时，层面的价值。次要目的是评估诊断的观察者间一致性。
对 375 例有 3 个层面的乳腺芯活检，首先对第 1 个层面进行复查并做出诊断，然后对第 2 和第 3 个层面进行复查并做出最终诊断。
对除钙化以外其他原因而行的 272 例芯活检中，有 4 例（1.5%，95%CI0.04%至 3%）和对钙化进行研究而行的 103 例活检中，有 13 例（13%，95%CI6%至 19%）的最终诊断与初始层面的诊断不同。本次研究的原始报告诊断和复查的最终诊断的观察者间一致性为 96%（κ0.947）。
本研究证实了对因乳腺钙化而行的活检的层面价值，但提示对于因其他原因而行的乳腺芯活检，常规层面的价值有限。
