Yale study finds 90 percent accuracy rate for needle biopsies in estimating severity of cancer in the breast

November 28, 2000

New Haven, Conn. - Physicians conducting needle biopsies with a higher gauge needle the size of a drinking straw and equipped with a vacuum suction device underestimated the severity of cancer in a breast on average in less than 10 percent of the cases, a study by Yale researchers shows.

This compares with an 18 percent rate of underestimation using a smaller, 14-gauge needle and automatic gun to extract breast tissue for testing for cancer, said the principal investigator, Liane Philpotts, assistant professor of diagnostic radiology at Yale School of Medicine.

"We looked at how often we did not fully diagnose the cancer," said Philpotts of the study published in the American Journal of Roentgenology. "It's not that cancers are missed. These are cases where we realized there was something wrong, but underestimated the severity of it."

Stereotactic core needle biopsy is widely used in place of surgical biopsy for the diagnosis of lesions of the breast diagnosed in mammograms. Although the needle biopsy has been shown to be highly accurate in diagnosing benign and malignant breast disease, it can underestimate cancer. This often results in the need for more surgery.

The retrospective study reviewed biopsies performed between October 1996 and March 1999 using an 11-gauge vacuum suction device. The vacuum suction device is an alternative to the automatic gun technique. Using either 14-gauge or 11-gauge probes, it can obtain core samples that are substantially larger than those obtained with the 14-gauge needle and automatic gun.

The study revealed that out of 753 biopsies in 688 patients, 178 were identified as cases of atypical ductal hyperplasia, or abnormal cell growth, ductal carcinoma in situ, or invasive disease.

The cases were then correlated to identify cases in which cancer was underestimated. Underestimated cancer cases were those in which either carcinoma was not diagnosed or invasive disease was not diagnosed. Of the 178 cases, 158 cases of cancer were ultimately diagnosed. Underestimation occurred in 15, or 9.5 percent, of cases.

The underestimation rate for calcification was 18 percent; for atypical, ductal hyperplasia, 26 percent; for masses, 1.6 percent, and for ductal carcinoma in situ, 18 percent.

No underestimations were found among cases in which the entire lesion identified in a mammogram was removed during the vacuum suction biopsy.

Philpotts said that although underestimation still occurs with the vacuum suction device, the data in the study helps to clarify which cases are more likely to result in underestimation. Underestimation is significantly more likely to occur in cases of calcification than in cases of masses. Also, the study showed that the greater the proportion of the lesion is removed, the less the underestimation.
-end-
The senior author of the study was Irena Tocino, professor and chief of breast imaging diagnostic radiology. Co-authors were Carol Lee, associate professor, diagnostic radiology; Laura Horvath, assistant professor, diagnostic radiology; Robert Lange, associate professor diagnostic radiology, and Darryl Carter, professor of pathology.

Yale University

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.