Article
Fast diagnosis of breast lesions – comparison of histological rapid embedded core-cut biopsies (CCB) to final histology from open excisions and cytological analysis of rinsed CCB-needles by ThinPrep
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Published: | March 20, 2006 |
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The optimal management of breast cancer (BC) therapy requires a fast and reliable preoperative diagnosis of breast lesions (BIRADS III–V). Within one hour histological diagnosis might be possible by combining CCB with rapid embedding (RE). In a prospective study this approach was compared with final histology of the excised tumors as well as with cytological analysis of the rinsing of the CCB-needles. From January 2002 to September 2004 212 CCB were performed. Comparison between cytological and histological diagnosis by rapid embedding was possible in 177 cases – with both methods 53%, i.e. 94 cases were diagnosed as benign and 22,6%, i.e. 40 as malignant. Discrepancy occurred in 43 cases (24,4%). 36 cases of BC were not diagnosed by cytology and 7 positive cytological analyses were not confirmed by histology. The comparison of the histology of RE and excised tumors in 103 cases showed in 94 cases identical results – 62times malignant and 32times benign. 7 cancers were not diagnosed by RE/CCB and 2 malignant tumors were not confirmed by final histology. Correlation of cytology and final histology could be studied in 159 cases – a correlation were seen in 110 cases (52 malignant and 58 benign). Therefore 49 analyses showed discrepant results. In conclusion cytology even using the ThinPrep method is not a valid method for diagnosis of breast lesions. By direct comparison RE from CCB shows a more reliable diagnostic tool. Even though 94/103, i.e. 91% correlation between RE and final histology could be determined, results of RE from CCB have to be used carefully.