<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_jou.2017.0039_s_001"><h3>Aim</h3><p>The aim of the study was to review two techniques that can be used to verify focal lesions in the breasts: fine-needle aspiration biopsy and core-needle biopsy.</p></sec><sec id="j_jou.2017.0039_s_002"><h3>Material and methods</h3><p>Fifty-five articles (original papers and reviews), half of them published within the past 5 years, were included in the analysis. The authors also took their own experience into account.</p></sec><sec id="j_jou.2017.0039_s_003"><h3>Results</h3><p>Pre-operative assessment of focal lesions in the breasts is crucial in the planning of further therapeutic management. The role of fine-needle aspiration biopsy has been reduced lately due to its low sensitivity and specificity as well as a high rate of non-diagnostic, suspicious and false negative results. This method does not enable one to differentiate between in situ and invasive disease. Currently, fine-needle biopsy is recommended for cystic lesions, suspected of being recurrences in the chest wall, and lymph node metastases. Core-needle biopsy is the basic diagnostic method of breast lesions. According to the recommendations of the Polish Ultrasound Society and American College of Radiology, BIRADS 4 and 5 lesions should be evaluated histopathologically. Core-needle biopsy makes it possible to establish a final diagnosis more frequently than fine-needle biopsy, both in the case of benign and malignant lesions. It delivers more information about the nature of a tumor (mutation of HER-2, estrogen and progesterone receptors and Ki-67 index). Its limitations include: underestimation of invasion and failure to recognize the components of ductal carcinoma in situ in papillary and atypical lesions. Single fine-needle aspiration biopsy is inexpensive, but when considering the cost of further diagnosis due to non-diagnostic, suspicious and atypical results, this method generates high additional costs.</p></sec><sec id="j_jou.2017.0039_s_004"><h3>Conclusions</h3><p>Microscopic verification of focal breast lesions is crucial for further therapeutic decisions. It has been proven that histopathological verification is more accurate and has more advantages than cytological assessment.</p></sec></abstract>

AimThe aim of the study was to review two techniques that can be used to verify focal lesions in the breasts: fine-needle aspiration biopsy and core-needle biopsy.Material and methodsFifty-five articles (original papers and reviews), half of them published within the past 5 years, were included in the analysis. The authors also took their own experience into account.ResultsPre-operative assessment of focal lesions in the breasts is crucial in the planning of further therapeutic management. The role of fine-needle aspiration biopsy has been reduced lately due to its low sensitivity and specificity as well as a high rate of non-diagnostic, suspicious and false negative results. This method does not enable one to differentiate between in situ and invasive disease. Currently, fine-needle biopsy is recommended for cystic lesions, suspected of being recurrences in the chest wall, and lymph node metastases. Core-needle biopsy is the basic diagnostic method of breast lesions. According to the recommendations of the Polish Ultrasound Society and American College of Radiology, BIRADS 4 and 5 lesions should be evaluated histopathologically. Core-needle biopsy makes it possible to establish a final diagnosis more frequently than fine-needle biopsy, both in the case of benign and malignant lesions. It delivers more information about the nature of a tumor (mutation of HER-2, estrogen and progesterone receptors and Ki-67 index). Its limitations include: underestimation of invasion and failure to recognize the components of ductal carcinoma in situ in papillary and atypical lesions. Single fine-needle aspiration biopsy is inexpensive, but when considering the cost of further diagnosis due to non-diagnostic, suspicious and atypical results, this method generates high additional costs.ConclusionsMicroscopic verification of focal breast lesions is crucial for further therapeutic decisions. It has been proven that histopathological verification is more accurate and has more advantages than cytological assessment.

Fine-needle versus core-needle biopsy – which one to choose in preoperative assessment of focal lesions in the breasts? Literature review

Journal of Ultrasonography

This work is licensed under the Creative Commons Attribution-NonCommercial 3.0 Public License.

AimThe aim of the study was to review two techniques that can be used to verify focal lesions in the breasts: fine-needle aspiration biopsy and core-needle...

Authors	CNB result	Results after surgical resection		Upgrading to malignant cancer
Authors	IDP with atypia (ADH/ALH)	DCIS	IDC/ILC	Upgrading to malignant cancer
Wiratkapun at al. (2013)*⁽⁴⁷⁾	32	10	2	12 (38%)
Rizzo at al. (2012)**⁽⁴⁹⁾	42	14	2	16 (38%)
Bianchi at al. (2015)***⁽⁵⁰⁾	46	7	15	22 (48%)

Authors	CNB result	Results after surgical resection			Upgrading to malignant cancer
Authors	IDP without atypia	Atypia (ADH or LN)	DCIS	IDC/ILC	Upgrading to malignant cancer
Wiratkapun at al. (2013)*⁽⁴⁷⁾	52	17 (33%)	0	0	0
Pareja at al. (2016)**⁽⁴⁸⁾	171	39 (22.8%)	2	2	4 (2.3%)
Rizzo at al. 2012***⁽⁴⁹⁾	234	42 (17.9%)	19	2	21 (9%)
Bianchi at al. 2015****⁽⁵⁰⁾	68	19 (27.9%)	5	4	9 (13.2%)

Authors	CNB result	Results after surgical resection		Total number of upgraded cases
Authors	ADH	DCIS	IDC	Total number of upgraded cases
Polat at al. (2012)*⁽²⁹⁾	320	38		38 (11.5%)
McGhan at al. (2012)**⁽³⁰⁾	114	14	6	20 (17.5%)
Hsu at al. (2010)***⁽³¹⁾	134	46	7	53 (40%)
Mesurolle at al. (2014)***⁽³²⁾	50	13	15	28 (56%)

Authors	False negative results in CNB
Schulz at al. (2013)*⁽³⁹⁾	37/205	18%
Caswell-Smith at al. (2016)**⁽⁴⁰⁾	59/287	20.6%
Park at al. (2014)***⁽⁴¹⁾	21/69	30.4%
Lee at al. (2013)****⁽⁴²⁾	116/248	46.8%

Fine-needle versus core-needle biopsy – which one to choose in preoperative assessment of focal lesions in the breasts? Literature review

Article Category: review-article

Publié en ligne: 29 déc. 2017

Pages: 267 - 274

Reçu: 19 juin 2017

Accepté: 14 sept. 2017

DOI: https://doi.org/10.15557/jou.2017.0039

Mots clés
core-needle biopsy, fine-needle aspiration biopsy, atypical ductal hyperplasia, ductal carcinoma, papillary lesions

© 2017 Ewa Łukasiewicz et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial 3.0 Public License.

Results presenting the percentage of IDP with atypia classified as in situ or invasive cancers upon surgical resection

Results showing the percentage of benign IDP verified as atypical or malignant in a postoperative examination after surgical resection

Comparison of histopathological assessment of atypical lesions based on CNB and postoperative specimens

False negative results concerning stromal invasion in CNB

Fine-needle versus core-needle biopsy – which one to choose in preoperative assessment of focal lesions in the breasts? Literature review

Article Category: review-article

Publié en ligne: 29 déc. 2017

Pages: 267 - 274

Reçu: 19 juin 2017

Accepté: 14 sept. 2017

DOI: https://doi.org/10.15557/jou.2017.0039

Mots cléscore-needle biopsy, fine-needle aspiration biopsy, atypical ductal hyperplasia, ductal carcinoma, papillary lesions

© 2017 Ewa Łukasiewicz et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial 3.0 Public License.

Results presenting the percentage of IDP with atypia classified as in situ or invasive cancers upon surgical resection

Results showing the percentage of benign IDP verified as atypical or malignant in a postoperative examination after surgical resection

Comparison of histopathological assessment of atypical lesions based on CNB and postoperative specimens

False negative results concerning stromal invasion in CNB

Mots clés
core-needle biopsy, fine-needle aspiration biopsy, atypical ductal hyperplasia, ductal carcinoma, papillary lesions