title: Reliability of prognostic factors in breast carcinoma determined by core needle biopsy.
abstract: OBJECTIVE
  The aim of this study was to evaluate the reliability of information obtained by core needle biopsy (CNB).
  
  
  METHODS
  We studied 111 women (112 lesions) with breast cancer who underwent CNB and subsequent surgical excision. Six factors (histological type, nuclear grade, histological grade, estrogen receptor (ER) status, progesterone receptor (PR) status, and human epidermal growth factor receptor-2 (HER2) status) were evaluated in a blinded fashion at CNB and at surgical excision.
  
  
  RESULTS
  The histological type at CNB correlated exactly with that of the excisional specimen in 83% (87/105) of the cases. Of the 45 in situ lesions at CNB, 16 (36%) were found to have invasive carcinoma at surgical excision. The difference between the specimens from CNB and those from surgery in terms of the absolute concordance rate and kappa statistic value were 61% with a fair kappa value (0.26) in the nuclear grade, 75% with a moderate kappa value (0.55) in the histological grade, 95% with an almost perfect kappa value (0.84) in ER, 88% with a substantial kappa value (0.70) in PR and 88% with a substantial kappa value (0.65) in HER2. Regarding the evaluation of nuclear and histological grades, a trend toward greater accuracy was observed when thicker specimens were used.
  
  
  CONCLUSIONS
  CNB provided reliable information on the histological type of invasive carcinoma. It also evaluated ER, PR and HER2 (only in cases where the score was 3+) accurately in spite of the limited quantity of the specimen obtained with the thin (16-gauge) needle.
authors.affiliation: Department of Pathology, Tohoku University Hospital, Sendai, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Usami
authors.forename: Takuya
authors.initials: T
authors.lastname: Moriya
authors.forename: Masakazu
authors.initials: M
authors.lastname: Amari
authors.forename: Akihiko
authors.initials: A
authors.lastname: Suzuki
authors.forename: Takanori
authors.initials: T
authors.lastname: Ishida
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohuchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D066246:ErbB Receptors / Q000032:analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D066246:ErbB Receptors