Diagnostic utility of tru-cut biopsy in the assesment of breast lesions

Aim: This report aims to assess the diagnostic utility of Tru-Cut biopsy in the diagnosis of breast mass in patients admitted to our breast unit in our clinic.Material and Methods: Between March 2013 and June 2018, In Ortadogu Private Hospital, Adana, 13.660 participants visited the breast unit and 472 participants of them aged 22-91 years experienced Tru-Cut biopsy(TCB) because of clinical doubt and/ or BI-RADS ( Breast Imaging Reporting and Data System ) III– V categorization. TCB specimens were compared with the histopathological reports of follow-up procedures including surgical procedures. When the pathology document was not compatible with clinical / image uncertainties, a biopsy was performed as a diagnostic method to exclude carcinoma.Results: The histopathological diagnosis of the TCB specimens showed that 237 cases (50.2%) were benign lesions, 219 (46.4%) were malignant lesions and 16 (3.4%) of them were disconcordance. Of the patients who underwent Tru-Cut biopsy, 256 (54.2%) had palpable and 216(45.8%) had nonpalpable lesions. Pathological results were not compatible with clinical / imaging suspicion in 3.4% of cases. TCB exhibited a sensitivity of 95.4%, 100% specificity, PPV of 100%, NPV of 96.1%, and diagnostic accuracy of 97.8%. There were no cases with false positivity.Conclussion: This study shows that Tru-Cut biopsy can safely be applied as a component of triple evaluation of suspected breast lesions. Multidisciplinary teamwork is crucial to implement the Tru-Cut biopsy, which replaces the present surgical approach to treat breast lesion and prevent from diagnostic inaccuracies.

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1. Vestito A, Mangieri FF, Gatta G, et al. Breast carcinoma in elderly women. Our experience. G Chir 2011;32:411-6.
2. Brenner RJ, Parisky Y. Alternative breast-imaging approaches.Radiol Clin North Am 2007;45:907-23.
3. Verenhitach BD, Elias S, Patrocínio AC, et al. Evaluation of the clinical efficacy of minimally invasive procedures for breast cancer screening at a teaching hospital. J Clin Pathol 2011;64:858-61.
4. Mendoza P, Lacambra M, Tan PH, et al. Fine needle aspiration cytology of the breast: the non-malignant categories. Patholog Res Int 2011;2011:547580.
5. Berner A, Sauer T. Fine-needle aspiration cytology of the breast. Ultrastruct Pathol 2011;35:162-7.
6. Kurita T, Tsuchiya SI, Watarai Y, et al. Roles of fine-needle aspiration and core needle biopsy in the diagnosis of breast cancer. Breast Cancer 2012;19:23-9.
7. Maniero MB, Philpotts LE, Lee CH, et al. Stereotaxic core needle biopsy of breast microcalcifications: correlation of target accuracy and diagnosis with lesion size. Radiology 1996;198:665-9.
8. Vargas H, Masood S. Implementation of a minimal invasive breast biopsy program in countries with limited resources. Breast J 2003;9:81-5.
9. Winchester David P. The national accreditation program for breast centers: a multidisciplinary approach to improve the quality of care for patients with diseases of the breast. Breast J 2008;14:409-11.
10. American Cancer Society. Cancer facts and figures. Atlanta: American Cancer Society; 2008.
11. Altıntas Y, Bayrak M. Association of knowledge and cultural perceptions of women with delay in breast cancer diagnosis: A single center experience. Ann Med Res 2019;26:240-5.
12. Rikabi A, Hussain S. Diagnostic usefulness of tru-cut biopsy in the diagnosis of breast lesions. Oman Med J. 2013;28:125-7.
13. Bdour M, Hourani S, Mefleh W, et al. Comparison between fine needle aspiration cytology and tru-cut biopsy in the diagnosis of breast cancer. J Surg Pak 2008;13:19-21.
14. Lacambra MD, Lam CC, Mendoza P, et al. Biopsy sampling of breast lesions: comparison of core needle- and vacuum-assisted breast biopsies. Breast Cancer Res Treat 2012;132:917-23.
15. Ahmed ME, Ahmad I, Akhtar S. Ultrasound guided fine needle aspiration cytology versus core biopsy in the preoperative assessment of non-palpable breast lesions. J Ayub Med Coll Abbottabad 2010;22:138-42.
16. Brunner AH, Sagmeister T, Kremer J, et al. The accuracy of frozen section analysis in ultrasound-guided core needle biopsy of breast lesions. BMC Cancer 2009;24:9:341.
17. Kulkarni D, Irvine T, Reyes RJ. The use of core biopsy imprint cytology in the ‘one-stop’ breast clinic. Eur J Surg Oncol 2009;35:1037-40.
18. Masood S. Core needle biopsy versus fine needle aspirationbiopsy: are there similar sampling and diagnostic issues? Clin Lab Med 2005;25:679-88.
19. Blamey RW, Cataliotti L. EUSOMA accreditation of breast units. Eur J Cancer 2006;42:1331-7.
20. Gentry C, Henry A. Sterotactic percutaneous breast biopsy: acomparative analysis between surgeons and radiologist. Breast J 1999;5:101-4.
21. Dowlatshahi K, Yaremko ML, Kluskens LF, et al. Non-palpablebreast lesions: findings of sterotaxic needle-core biopsy and fineneedle aspiration cytology. Radiology 1991;181:745-50.
22. Masood S. Fine needle aspiration biopsy of nonpalpable breast lesions. In: Schmidt W, editor. Cytopathology annual. Chicago: ASCP Press; 1994. p. 33-63.
23. Masood S. Recent updates in breast fine needle aspiration biopsy.Breast J 1996;2:1–12.
24. Parker SH. Needle selection. In: Parker SH, Jobe WE, editors.Percutaneous breast biopsy. New York: Raven Press; 1993. p. 7-14.
25. Perry NM. on behalf of EUSOMA Working Party (revised version of the original EUSOMA Position paper published in 2001). Eur J Cancer 2001;37:159-72.