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Concordance between core biopsy and anatomopathological examination of surgical specimen in patients with breast cancer

INTRODUCTION: Core biopsy (CB) has increasingly gained importance in the diagnosis and management of breast cancer due to its cost effectiveness and high accuracy. However, it is debatable whether this method is particularly suitable for the characterization of histological type and tumor differentiation, since the biopsied region may not be representative of the tumor as a whole. OBJECTIVE: To evaluate the concordance between the biopsy and the surgical specimen anatomopathological findings. MATERIAL AND METHODS: We carried out a retrospective study involving all patients with breast cancer undergoing modified radical mastectomy or quadrantectomy in our service from January 2007 to December 2009, thus analyzing the concordance rate between the results of breast tumor CB and surgical specimen anatomopathology. Histological type, tumor differentiation grade and lymphovascular invasion were assessed as variables. RESULTS: The results show a concordance rate of 76% for the histological type between both methods. As to tumor grade, concordance rate was 50%, in which CB was prone to underestimate grade. Regarding the presence of lymphovascular invasion, the concordance was 62.09%, with 100% positive predictive value but low sensitivity (29%). CONCLUSION: These findings suggest that CB is a suitable method for histological diagnosis of breast cancer, although it has a high discordance rate for tumor grade and lymphovascular invasion in comparison with specimen anatomopathologic exam, tending to underestimate tumor aggressiveness.

Core biopsy; Needle biopsy; Breast neoplasms; Prognostic factors; Diagnosis


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