title: Changing to core biopsy in an NHS breast screening unit.
abstract: We recently changed from using fine needle aspiration cytology to using core biopsy exclusively in the assessment of screen detected abnormalities. Two hundred and two biopsies (1% of women screened) were performed. Surgical histological confirmation was obtained in 111 patients (101 malignant and 10 benign). The remaining patients were either returned to standard 3-yearly screening or early repeat screening after 1 year. Analysis of the results was performed in accordance with the standards specified in the National Health Service Breast Screening Programme (NHSBSP) Publication Number 22. Absolute sensitivity was 89.3%, complete sensitivity was 93.2%, specificity (including patients undergoing both surgical excision and follow-up) was 88.7%. The predictive value of a positive (malignant) core biopsy result was 100%. The false negative rate was 3.9%. Twelve (5.9%) biopsies were classified inadequate for diagnosis. Core biopsy is a safe and accurate way of assessing screen detected abnormalities and can be used as a substitute for fine needle aspiration cytology with results that exceed the National Health Service Breast Screening Programme target standards, even in the learning phase.
authors.affiliation: Department of Radiology, Addenbrooke's Hospital and Cambridge University, UK.
authors.forename: P D
authors.initials: PD
authors.lastname: Britton
authors.forename: C D
authors.initials: CD
authors.lastname: Flower
authors.forename: A H
authors.initials: AH
authors.lastname: Freeman
authors.forename: R
authors.initials: R
authors.lastname: Sinnatamby
authors.forename: R
authors.initials: R
authors.lastname: Warren
authors.forename: M J
authors.initials: MJ
authors.lastname: Goddard
authors.forename: D G
authors.initials: DG
authors.lastname: Wight
authors.forename: L
authors.initials: L
authors.lastname: Bobrow
mesh_terms: D001706:Biopsy / Q000379:methods*; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013222:State Medicine; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary; D006113:United Kingdom