Abstract:

Objective

To investigate the accuracy of preoperative core needle biopsy (CNB) in breast cancer patients, the influencing factors of accuracy and the impact on patients' prognosis.

Methods

The clinicopathological data of 1 797 female patients with breast cancer who underwent surgery in the First Hospital of Jilin University from January 2009 to December 2013 were retrospectively analyzed. Totally 795 cases were diagnosed by CNB, and 1 002 cases were diagnosed by open surgery biopsy (OSB). According to the 1 ∶1 matching principle (including T stage, N stage, ER status, PR status and HER-2 status),1 106 patients were enrolled, including 553 cases diagnosed by CNB and 553 cases diagnosed by OSB. The clinicopathological features, DFS and OS of two groups were also compared. The clinicopathological features were analyzed using the chi-square test or the Fisher exact probability test. The survival rate was calculated with Kaplan-Meier method and survival difference was compared with the Log-rank test. The Cox proportional hazards model was used to analyze the prognostic factors of breast cancer patients.

Results

The detection rate of breast cancer by CNB was 89.7% (496/553). The pathological detection rate by CNB was significantly lower when the primary lesions were associated with calcification(χ² =17.965,P ＜0.001)or the patients were diagnosed as having intraductal carcinoma, intraductal carcinoma associated with microinvasion and atypical hyperplasia (compared with the invasive carcinoma, all P＜0.025). All patients were followed up for median 30.5 months (6.9-66.5 months). Compared with OSB group, the local recurrence rate of CNB group was not significantly increased (P=0.726). The choice of biopsy types (CNB vs OSB) did not significantly influence the DFS and OS (OR=1.780,95%CI: 0.919-3.448, P=0.087; OR=1.336, 95%CI: 0.627-2.848, P=0.453) of breast cancer patients. The interval between biopsy and surgery showed no significant impact on the DFS and OS (OR=0.596, 95%CI: 0.353-1.008, P=0.054; OR=0.702, 95%CI: 0.397-1.240, P=0.223)either.

Conclusions

CNB is a safe method for the diagnosis of breast cancer, with no obvious impact on the prognosis of the patients. It is worth of clinical application.

Key words: Breast neoplasms, Biopsy, needle, Neoplasm recurrence, local, Survival analysis