Utility Of Breast Cancer Diagnosis And Accuracy Of Immunohistochemistry Of 16-Gange Coreneedle Biopsy

Objective:1.To assess theaccuracy of ultrasound-guided 16G core needle biopsy in dia-gnosis of breast cancer;evaluate underestimate rates of breast lesionsand possi-ble causes.2.To evaluate the accuracyof ER,PR,C-erbB-2/Her-2 status between 16-Gange core needle biopsy and open excision biopsy.Materials and Methods:1.Betwwen January 2015 and June 2016,373 preoperative ultrasound-guided 16G CNB,and then surgical diagnosed as breast cancer cases were reviewed.Compared with 16G CNB pathology and surgical pathology,evaluation of dia-gnostic accuracy.Combined with the general data,physical examination,ultras-ound,to predicted the reasons for different diagnosis.2.Betwwen January 2015 and June 2016,285 preoperative ultrasound-guided 16-G CNB,and then surgery diagonsed breast invasivecarcinoma cases were rev-iewed.Evaluate the accuracy of ER,PR,C-erbB-2/Her-2 status between 16-Gange core needle biopsy and open excision biopsy.Result:1.In 373 preoperative ultrasound-guided 16G core needle biopsy,and then sur-gical diagnosed as breast cancer cases,benign in 5.6%,high-risk in 2.7%,malign-ant in 91.7%.The pathologic overall agreement rates was 87.1%.48 cases were not matched,including 21 cases(5.6%)of false negative,26 cases(9.7%)underestim-ated,1 case(0.3%)overestimated.Among 26 underestimated cases,16 cases(61.5%)were ductal carcinoma in situ,9 cases(34.1%)were atypicalductal hyperplas-ia,5 cases upgrade to uctal carcinoma in situ and 4 cases up-grade to breast invasive carcinoma.Total 53 cases were diagnosed as ductal carcinoma in situ,16(30.2%)cases were proved to be underestimated.Univariate analysis of pathol-ogical inconsistency occurred,older than 70 years of age,lesthan 10mm diametertumor mass,ultrasonography no visible mass lesions,low-er BI-RADS3 lesions,could significantly reduce the accuracy of CNB diagnosi-s,P<0.05;and mass si-te,ultrasound calcification,blood flow signal,were not the main reason for the a-ccuracy of CNB diagnosis,P>0.05.2.285 preoperative ultrasound-guided 16G core needle biopsy,and then surgerydiagonsed breast invasive carcinoma cases were reviewed,core needle bispsy ERpositive 208 cases(72.3%),PR positive 189 cases(66.3%),C-erbB-2/Her-2 positive70 cases(24.6%);while surgical ER positive 216 cases(75.8%),PR positive 202cases(71.9%),C-erbB-2/Her-2 positive 67 cases(23.5%).There were some differec-es between the two groups,but the differences were not statistically significant(P>0.05).The agreement rates of ER,PR,C-erbB-2/Her-2 expression were 94.3%,92.0%and 93.3%.The pathologic features of ER and PR were higher than t-hoseof puncture pathology,P<0.05.Conclusion:1.Ultrasound-guided 16G core needle biopsy is accurate for pathological diagn-osis and ER,PR,C-erbB-2/Her-2 detection in breast cancer.2.Ultrasound-guided 16G core needle biopsy diagnosis of ductal carcinoma in situ,atypical hyperplasia have high underestimate rates.Older than 70 years ofage,less than 10mm diameter tumor mass,ultrasonography no visible mass lesio-ns and lower BI-RADS3 lesions can significantly reduce the accuracy of coreneedle biopsy diagnosis.In these conditions,vacuum-assisted biopsy or surgicalresection biopsy is necessary.