Biópsia com agulha grossa guiada por ultrassonografia para o diagnóstico dos tumores fibroepiteliais da mama

Abstract

Kappa. RESULTADOS: a biópsia excisional revelou 40 casos de fibroadenoma (57,1%), 19 de tumor filoide (27,2%) e 11 de fibroesclerose (15,7%). A taxa de concordância para o fibroadenoma foi substancial (k = 0,68; IC95% = 0,45 -0,91), quase perfeita para o tumor filoide (k = 0,81; IC95% = 0,57 -1,0) e moderada para a fibroesclerose (k = 0,58; IC95% = 0,36 -0,90). CONCLUSÕES: a biópsia percutânea com agulha grossa é propedêutica minimamente invasiva que tem taxas de concordância com a biópsia excisional, de " substancial " a " quase perfeita " . A fibroesclerose deve ser considerada no diagnóstico diferencial dos tumores fibroepiteliais. Abstract PURPOSE: to evaluate the concordance rate of ultrasound-guided core needle biopsy followed by excisional biopsy in palpable breast lumps, suggestive of fibroepithelial tumors. METHOD: a retrospective study included 70 biopsies with a histological diagnosis of fibroepithelial tumor in 67 out of 531 patients with breast lesions submitted to ultrasound-guided core needle biopsy with a high frequency (7.5 MHz) linear transducer, using an automatic Bard-Magnum gun and a 14-gauge needle. Cases with a diagnosis of fibroepithelial tumor by core needle biopsy or excisional biopsy and with a diagnosis of fibrosclerosis were included in the study. The agreement between the two biopsy methods was assessed using the Kappa coefficient. RESULTS: excisional biopsy revealed 40 cases of fibroadenoma (57.1%), 19 cases of phyllodes tumor (27.2%), and 11 cases of fibrosclerosis (15.7%). The concordance rate for fibroadenoma was substantial (k = 0.68, 95%CI = 0.45 -0.91), almost perfect for the phyllodes tumor (k = 0.81, 95%CI = 0.57 -1.0), and moderate for fibrosclerosis (k = 0.58, 95%CI = 0.36 -0.90). CONCLUSIONS: the core needle biopsy is a minimally invasive method that has " substantial " to " almost perfect " concordance rate with excisional biopsy. Fibrosclerosis should be considered in the differential diagnosis of fibroepithelial tumors.