Papillary lesions of the breast--accuracy of core biopsy.
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.
Tse
Gary M
GM
Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong. garytse@cuhk.edu.hk
Tan
Puay-Hoon
PH
Lacambra
Maribel D
MD
Jara-Lazaro
Ana Richelia
AR
Chan
Siu-Ki
SK
Lui
Philip C
PC
Ma
Tony K F
TK
Vong
Joaquim S
JS
Ng
David C H
DC
Shi
Hui-Juan
HJ
Lam
Wynnie W
WW
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
C081876:CKAP4 protein, human; D053547:Keratin-14; D008565:Membrane Proteins; D011960:Receptors, Estrogen