title: Does core needle breast biopsy accurately reflect breast pathology?
abstract: BACKGROUND
  Core needle breast biopsy (CB) has replaced excisional biopsy as the initial diagnostic biopsy procedure for many suspicious breast lesions; however, CB remains a sampling procedure. The purpose of this study was to determine the degree of agreement between histology obtained at CB and that obtained at a subsequent excisional procedure (EP). We hypothesized a high degree of agreement.
  
  
  METHODS
  Data were collected prospectively for 3035 CBs performed by breast radiologists using either ultrasound or stereotactic guidance between January 1995 and July 2002, 1410 (46%) of which had a subsequent EP within 1 year. Histologic categories were defined as invasive breast cancer, duct carcinoma in-situ, atypia/lobular carcinoma in-situ, and benign. The principal histology (PH) from CB and EP was identified and compared.
  
  
  RESULTS
  Overall, there was moderate agreement (kappa=0.669) between CB and EP histology. Complete agreement occurred in 1168 (83%) procedures. For the remaining 242, the PH was identified only at CB for 78 (5%) procedures, and only after EP for 164 (12%) procedures.
  
  
  CONCLUSIONS
  Although the majority (83%) of CB and EP demonstrated exact histologic agreement, CB was diagnostic for 1246 (88%) procedures.
authors: Cleveland Clinic Breast Center and the Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, A-80, Cleveland, OH 44195, USA.
authors: Joseph P
authors: JP
authors: Crowe
authors: Alice
authors: A
authors: Rim
authors: Rebecca J
authors: RJ
authors: Patrick
authors: Lisa A
authors: LA
authors: Rybicki
authors: Sharon F
authors: SF
authors: Grundfest-Broniatowski
authors: Julian A
authors: JA
authors: Kim
authors: Katherine B
authors: KB
authors: Lee
mesh_terms: D001706:Biopsy; D001707:Biopsy, Needle / Q000592:standards*; D001940:Breast / Q000473:pathology*; D005260:Female; D006801:Humans; D011446:Prospective Studies; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted; D016217:Ultrasonography, Mammary