Comparison Of Clinical Application Of Core Needle Biopsy And Vacuum-assisted Biopsy

Background and Objective:Breast cancer is the most common type of malignant tumor in women,according to the data of breast cancer incidence in 2009 released by the National Cancer Center and the Ministry of Health's Disease Prevention and Control Bureau in 2012,the incidence of breast cancer in tumor registries nationwide ranks the first among female malignant tumors,with the total incidence(crude rate)of female breast cancer nationwide being 42.55/100,000.Early detection and diagnosis are the key points of breast cancer prevention and treatment.Therefore,effective screening for breast cancer is particularly important.In recent years,with the progress of breast cancer screening,more and more early breast cancers have been discovered and timely treatment,and the prognosis is obviously better than the past.Breast cancer palpation,mammography,breast ultrasound,breast magnetic resonance examination,etc.can be used to detect suspicious lesions of breast cancer early,and combined with appropriate histopathological examination(referred to as biopsy)to achieve the purpose of diagnosis.At present,common breast cancer biopsy techniques include image-positioning core needle biopsy(CNB),needle aspiration cytology(FNAC)and vacuum-assisted biopsy(VAB).Both of them can provide the pathological results of patients for auxiliary diagnosis and treatment.The purpose of this study was to explore the clinical diagnostic value of core needle biopsy and vacuum-assisted biopsy for patients with biopsy indications,and to compare the differences between the two methods in breast diseases diagnosis,immunohistochemical judgment and fluorescence in situ hybridization(FISH)detection.Objects and methods:A total of 150 patients who received core needle biopsy from March 2011 to November 2017 were enrolled,and 150 patients with similar age,mass size,and BI-RADS classification were treated with vacuum-assisted biopsy.Cases were paired and analyzed.In the core needle biopsy group,if the puncture result was benign,lumpectomy was performed at an appropriate time.And if the result of puncture was malignant,the radical operation for breast cancer was time limited.Surgical specimens were sent for postoperative routine pathological examination.In the vacuum-assisted biopsy group,all the obtained specimens were examined by intraoperative frozen section and postoperative paraffin pathology.If the diagnosis is benign,the lesion had been completely removed.If breast cancer is diagnosed,radical breast cancer surgery will be performed on the day or the second day after the operation.The diagnostic accuracy and the coincidence rate of immunohistochemistry and FISH test before and after operation were statistically analyzed.The effects of clinical imaging,tumor size,pathological type of mass,amount of puncture tissue on the results of biopsy were also analyzed.Result:The data of the patients in the comparison between the core needle biopsy group and the vacuum-assisted biopsy group showed no significant difference in age,lesion size,BI-RADS classification,and final pathological composition(P>0.05).By comparing the coincidence rate of pathological results,the consistency of ER,PR,Herb-2,ki-67 between the two groups before and after surgery,the diagnostic accuracy of the two groups was judged.Through data analysis,it was found that the sensitivity of core needle biopsy and vacuum-assisted biopsy were 98.9%and 99.2%,and the specificity was 100%.There was no statistical difference(P>0.05).There were different indicators in the four indicators,among which the consistency was relatively high in the vacuum-assisted biopsy group,and the agreement rate was 98%.The core needle biopsy was slightly lower than the vacuum-assisted biopsy group of 96.67%.But there was no statistically significant difference(P>0.05).In the VAB group,5 of 65 cases of DCIS were IDC after operation,and no error was found in ADH(Atypical ductal hyperplasia)cases identified by VAB.In the CNB group,22 of 64 cases of DCIS were IDC and 1 of 2 cases of ADH was IDC.There were significant statistical differences between the two groups(P=0.03).By comparing the operating times of the two biopsy methods,VAB required significantly longer time(P<0.01)than CNB,the mean total operative time of VAB was 239.4 s,and the mean total operative time of CNB was 178.7 s.The total operation time of the VAB is longer because of the increased number of biopsies.Despite the increase in time and number of biopsies,patients reported a similar degree of pain in the VAB as CNB.Conclusion:Core needle biopsy is a reliable diagnostic technique that is simple,,safe and with fewer complications.There is a strong consistency in surgical resection and pathological diagnosis,which may exempt part of benign tumor surgery,and is worthy of clinical application.The vacuum-assisted biopsy is not only safe,but also has fewer complications.It has a thicker needle and more adequate material,which may have more advantageous in the judgment of immunohistochemistry,and can greatly improve the clinical detection rate of early breast cancer,and the pathological coincidence rate is more obvious.It can significantly reduce the underestimate rate of DCIS,ADH.At the same time,the patients diagnosed as benign lesions can be cured and avoid the second surgery.