Diagnostic accuracy of needle-localized open breast biopsy for impalpable breast disease.
BACKGROUND
Needle-localized open breast biopsy (NLBB) is considered the gold standard procedure for the diagnosis of impalpable breast disease. In an observational follow-up study the sensitivity and negative predictive value of this procedure was determined in a clinical population with long-term follow-up.


METHODS
Some 199 consecutive patients with a benign histological diagnosis on NLBB were followed for the occurrence of breast cancer, using information from the Dutch National Morbid-Anatomical Record Department. Based on a review of mammograms and histological slides, an expert panel decided whether the carcinomas detected during follow-up were newly developed, or were present already at the time of the NLBB.


RESULTS
After a median follow-up of 60.5 months, seven carcinomas were detected. At panel review, six appeared to have been missed by NLBB. The sensitivity of NLBB was 99 per cent after 2 years of follow-up, but dropped to 96 per cent after 5 years. Similarly, the negative predictive value dropped from 99 per cent after 2 years to 94 per cent after 5 years of follow-up.


CONCLUSIONS
NLBB is an accurate diagnostic procedure for the evaluation of impalpable breast disease. However, with longer follow-up the accuracy becomes lower than generally reported.
Verkooijen
H M
HM
Departments of Surgery, Radiology and Pathology, and Julius Center for Patient Oriented Research, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Peeters
P H
PH
Pijnappel
R M
RM
Koot
V C
VC
Schipper
M E
ME
Borel Rinkes
I H
IH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods* / Q000592:standards; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010173:Palpation; D012680:Sensitivity and Specificity