[Sensitivity and speed of cell and tissue pre-diagnosis among breast cancer patients undergoing primary surgical treatment in two hospitals, determined with the aid of PALGA data].
OBJECTIVE
Result and process testing of cell and tissue diagnostics, including the sentinel-gland procedure, executed on patients who underwent a primary surgical intervention for mammary carcinoma.


METHODS
Retrospective.


METHODS
In a group of 191 women who underwent 192 primary surgical interventions for breast cancer in 2002, data from the Pathological-Anatomical National Computerised Archive (PALGA) were examined with regard to which form of cell or tissue diagnosis was used and in how many stages the cancer diagnosis was morphologically established with sufficient certainty.


RESULTS
In three-quarters of the women the diagnosis 'cancer' was established with certainty in the first stage. When the initial diagnosis was made using fine-needle cytological puncture, 35 of the 81 women had to undergo a second diagnostic test; with histological tests using needle biopsies this was 10 out of 92. The false-negative chance of fine-needle cytological tests was 13% (95% CI: 8-22) and for tests involving large-core needle biopsies 14% (95% CI: 8-23). A delay in treatment of more than 4 months occurred in 6 women due to the cancer being missed. A sentinel-gland procedure was performed on 58% of the women. In 33 women who underwent pre-operative ultrasound with fine-needle cytological testing of the axillary glands, the sensitivity for axillary gland metastases was 74% (95% CI: 53-87).


CONCLUSIONS
Looked at in terms of the practical guideline for diagnosis of breast cancer the cell and tissue diagnoses were adequate, but the standards prescribed in that guideline for the chances of a false-negative (5%) were exceeded.
Giard
R W
RW
Medisch Centrum Rijnmond-Zuid, locatie Clara, afd. Klinische Pathologie, Postbus 9119, 3007 AC Rotterdam. giard@mcrz.nl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary