Reliability of Prognostic Factors in Breast Carcinoma Determined by Core Needle Biopsy

doi:10.1093/jjco/hym021

Japanese Journal of Clinical Oncology Advance Access published online on May 7, 2007
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hym021

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Reliability of Prognostic Factors in Breast Carcinoma Determined by Core Needle Biopsy

Shin Usami¹^,2, Takuya Moriya¹^,, Masakazu Amari², Akihiko Suzuki², Takanori Ishida², Hironobu Sasano¹ and Noriaki Ohuchi²

¹ Department of Pathology
² Breast and Endocrine Surgery, Tohoku University Hospital, Sendai, Japan

For reprints and all correspondence: Takuya Moriya, Department of Pathology, Tohoku University Hospital. 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. E-mail: moriya{at}patholo2.med.tohoku.ac.jp

Received October 17, 2006; accepted November 22, 2006

Objective: The aim of this study was to evaluate the reliability of informationobtained by core needle biopsy (CNB).

Methods: We studied 111 women (112 lesions) with breast cancer who underwentCNB and subsequent surgical excision. Six factors (histologicaltype, nuclear grade, histological grade, estrogen receptor (ER)status, progesterone receptor (PR) status, and human epidermalgrowth factor receptor-2 (HER2) status) were evaluated in ablinded fashion at CNB and at surgical excision.

Results: The histological type at CNB correlated exactly with that ofthe excisional specimen in 83% (87/105) of the cases. Of the45 in situ lesions at CNB, 16 (36%) were found to have invasivecarcinoma at surgical excision. The difference between the specimensfrom CNB and those from surgery in terms of the absolute concordancerate and ${kappa}$ statistic value were 61% with a fair ${kappa}$ value (0.26)in the nuclear grade, 75% with a moderate ${kappa}$ value (0.55) in thehistological grade, 95% with an almost perfect ${kappa}$ value (0.84)in ER, 88% with a substantial ${kappa}$ value (0.70) in PR and 88% witha substantial ${kappa}$ value (0.65) in HER2. Regarding the evaluationof nuclear and histological grades, a trend toward greater accuracywas observed when thicker specimens were used.

Conclusions: CNB provided reliable information on the histological type ofinvasive carcinoma. It also evaluated ER, PR and HER2 (onlyin cases where the score was 3+) accurately in spite of thelimited quantity of the specimen obtained with the thin (16-gauge)needle.

Key Words: breast cancer • core needle biopsy • HER2 • hormone receptor • prognostic factor

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