Tikku Gargi, Umap Pradeep
Department of Pathology, Government Medical College and Hospital, NAGPUR, INDIA.
Turk Patoloji Derg. 2016;32(1):1-7. doi: 10.5146/tjpath.2015.01335.
The purpose of this study was to evaluate the utility of core needle biopsy as a diagnostic tool for palpable breast lumps in developing countries as compared to fine needle aspiration cytology.
All patients attending the surgery outpatient department with palpable breast lumps were subjected to fine needle aspiration cytology and core needle biopsy by the same operator in a single session. Fine needle aspiration cytology was performed by the standard technique. Core needle biopsy was done freehand using a 14G manual core biopsy needle. Reporting categories of the two techniques were taken from the standard National Health Service Breast Screening Programme criteria and were compared with the final histopathology results.
A total of 107 patients underwent fine needle aspiration cytology and core needle biopsy simultaneously. Histopathology was available for 85 cases. Statistical analysis of fine needle aspiration cytology and core needle biopsy showed no significant difference between the diagnoses offered by core needle biopsy and histopathology while there was a significant difference between fine needle aspiration cytology and histopathology diagnoses.
Core needle biopsy detected more breast carcinomas as compared to fine needle aspiration cytology with a sensitivity 95.83% as opposed to 64.58%. Though both the techniques were equally specific (100%), Core needle biopsy was able to correctly categorize borderline / inadequate lesions into definitely benign and malignant categories. We suggest that core needle biopsy should be preferred over fine needle aspiration cytology for the diagnosis of palpable breast lumps with fine needle aspiration cytology being reserved for definitely benign lesions.
本研究旨在评估与细针穿刺细胞学检查相比，粗针活检作为发展中国家可触及乳腺肿块诊断工具的效用。
所有到外科门诊就诊的可触及乳腺肿块患者，由同一名操作人员在同一时段进行细针穿刺细胞学检查和粗针活检。细针穿刺细胞学检查采用标准技术。粗针活检徒手操作，使用14G手动粗针活检针。两种技术的报告分类取自英国国家医疗服务体系乳腺筛查计划的标准，并与最终组织病理学结果进行比较。
共有107例患者同时接受了细针穿刺细胞学检查和粗针活检。85例有组织病理学结果。细针穿刺细胞学检查和粗针活检的统计分析显示，粗针活检提供的诊断与组织病理学诊断之间无显著差异，而细针穿刺细胞学检查与组织病理学诊断之间存在显著差异。
与细针穿刺细胞学检查相比，粗针活检检测出更多乳腺癌，其敏感性为95.83%，而细针穿刺细胞学检查为64.58%。虽然两种技术的特异性均为100%，但粗针活检能够将临界/不充分病变正确分类为明确的良性和恶性类别。我们建议，对于可触及乳腺肿块的诊断，应首选粗针活检，细针穿刺细胞学检查则仅用于明确的良性病变。
