Reliability of prognostic factors in breast carcinoma determined by core needle biopsy

Abstract

Objective: The aim of this study was to evaluate the reliability of information obtained by core needle biopsy (CNB). Methods: We studied 111 women (112 lesions) with breast cancer who underwent CNB and subsequent surgical excision. Six factors (histological type, nuclear grade, histological grade, estrogen receptor (ER) status, progesterone receptor (PR) status, and human epidermal growth factor receptor-2 (HER2) status) were evaluated in a blinded fashion at CNB and at surgical excision. Results: The histological typeat CNB correlated exactly with that of the excisional specimen in 83% (87/105) of the cases. Of the 45 in situ lesions at CNB, 16 (36%) were found to have invasive carcinoma at surgical excision. The difference between the specimens from CNB and those from surgery in terms of the absolute concordance rate and κ statistic value were 61% with a fair κ value (0.26) in the nuclear grade, 75% with a moderate κ value (0.55) in the histological grade, 95% with an almost perfect κ value (0.84) in ER, 88% with a substantial κ value (0.70) in PR and 88% with a substantial κ value (0.65) in HER2. Regarding the evaluation of nuclear and histological grades, a trend toward greater accuracy was observed when thicker specimens were used. Conclusions: CNB provided reliable information on the histological type of invasive carcinoma. It also evaluated ER, PR and HER2 (only in cases where the score was 3+) accurately in spite of the limited quantity of the specimen obtained with the thin (16-gauge) needle. © 2007 Foundation for Promotion of Cancer Research.