title: Papillary lesions of the breast--accuracy of core biopsy.
abstract: OBJECTIVE
  To assess the accuracy of diagnosing papillary breast lesions in core needle biopsy.
  
  
  RESULTS
  One hundred biopsy specimens of papillary breast lesions were reviewed and compared with the final excisional diagnoses. The discordant biopsy specimens were stained for oestrogen receptor (ER), cytokeratin (CK) 14 and p63, and these specimens were reclassified based on these results. The overall core biopsy accuracy, false-positive and false-negative rate were 79%, 5% and 16%, respectively. A benign core biopsy specimen diagnosis gave a false-negative rate of 10%, and malignant core biopsy specimen diagnosis did not give any false-positive results. Using homogeneous ER (epithelial), positive CK14 (epithelial) and p63 (myoepithelial) immunoreactivity as benign criteria, the discordant rate was reduced by 30% and 69% when using all three or two of these three criteria for diagnosis. However, false-positive and -negative cases could not be totally eliminated.
  
  
  CONCLUSIONS
  Immunohistochemistry is helpful in core biopsy diagnosis of papillary breast lesions, but some cases remained misdiagnosed.
authors.affiliation: Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong. garytse@cuhk.edu.hk
authors.forename: Gary M
authors.initials: GM
authors.lastname: Tse
authors.forename: Puay-Hoon
authors.initials: PH
authors.lastname: Tan
authors.forename: Maribel D
authors.initials: MD
authors.lastname: Lacambra
authors.forename: Ana Richelia
authors.initials: AR
authors.lastname: Jara-Lazaro
authors.forename: Siu-Ki
authors.initials: SK
authors.lastname: Chan
authors.forename: Philip C
authors.initials: PC
authors.lastname: Lui
authors.forename: Tony K F
authors.initials: TK
authors.lastname: Ma
authors.forename: Joaquim S
authors.initials: JS
authors.lastname: Vong
authors.forename: David C H
authors.initials: DC
authors.lastname: Ng
authors.forename: Hui-Juan
authors.initials: HJ
authors.lastname: Shi
authors.forename: Wynnie W
authors.initials: WW
authors.lastname: Lam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D002291:Carcinoma, Papillary / Q000473:pathology*; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053547:Keratin-14 / Q000032:analysis; D008565:Membrane Proteins / Q000032:analysis; D008875:Middle Aged; D010212:Papilloma / Q000473:pathology*; D011960:Receptors, Estrogen / Q000032:analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: C081876:CKAP4 protein, human; D053547:Keratin-14; D008565:Membrane Proteins; D011960:Receptors, Estrogen