title: A comparative analysis of core needle biopsy and final excision for breast cancer: histology and marker expression.
abstract: BACKGROUND
  Core needle biopsy (CNB) is used increasingly not only to diagnose breast cancer, but to determine tumor histology, grade and marker expression, select neoadjuvant therapy, and predict sentinel lymph node status. Thus, we undertook this study to evaluate the accuracy of CNB as a predictor of breast cancer histology and marker expression.
  
  
  METHODS
  We identified 209 Breast Cancer Registry cases with a preoperative CNB and reviewed all clinicopathologic data for accuracy. Statistical analysis was performed with statistical software.
  
  
  RESULTS
  CNB unequivocally showed cancer in 93%. Exact tumor histology concordance was 86%. Ductal carcinoma in situ on CNB was upgraded to invasive cancer in 23%. Concordance was substantial for estrogen receptor expression (88%, κ = .71), but kappa values were less than .6 for tumor grade, mitotic rate, progesterone receptor (PR), Ki-67, HER-2/neu, and p53 expression.
  
  
  CONCLUSIONS
  Reliance on CNB grade and marker expression for critical decision making may be inadvisable. Further study is warranted to optimize breast cancer patient care.
authors.affiliation: Department of Surgery, NorthShore University Healthcare System, Skokie Hospital, Skokie, IL 60076, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Ough
authors.forename: Jose
authors.initials: J
authors.lastname: Velasco
authors.forename: Tina J
authors.initials: TJ
authors.lastname: Hieken
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000096:biosynthesis* / Q000097:blood; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011960:Receptors, Estrogen / Q000096:biosynthesis* / Q000097:blood; D015203:Reproducibility of Results
chemical_list: D014408:Biomarkers, Tumor; D011960:Receptors, Estrogen