title: Evaluation of the clinical efficacy of minimally invasive procedures for breast cancer screening at a teaching hospital.
abstract: OBJECTIVE
  To assess the clinical efficacy of diagnostic procedures for breast cancer at a teaching hospital using internal auditing tools and quality control measures.
  
  
  METHODS
  A retrospective assessment of 500 patients who underwent core needle biopsy (wide-bore needle biopsy; WBN) of palpable or non-palpable breast nodes that were submitted for at least one cytological examination (fine needle aspiration (FNA) cytology and/or imprint of a WBN specimen). For statistical analysis the auditing tool and quality control proposed by the National Health Service breast screening programme was utilised.
  
  
  RESULTS
  For FNA, full specificity, positive predictive value, inadequate rates and suspicious rates were satisfactory while absolute sensitivity, complete sensitivity, false negatives and false positives were unsatisfactory. For imprint, absolute sensitivity, complete sensitivity, inadequate rate from cancers and suspicious rates were satisfactory, and the remaining indicators were unsatisfactory. WBN displayed the best performance with absolute sensitivity, complete sensitivity, false negative, suspicious rates, full specificity and predictive value showing satisfactory results and only one unsatisfactory result (false positive).
  
  
  CONCLUSIONS
  Based on an overall analysis, WBN displayed the highest clinical efficacy compared with FNA and imprint, and demonstrated adequate safety for confirming the appropriate diagnosis and management of patients, ensuring the efficacy of the service.
authors.affiliation: Department of Gynecology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Beatriz Daou
authors.initials: BD
authors.lastname: Verenhitach
authors.forename: Simone
authors.initials: S
authors.lastname: Elias
authors.forename: Ana Claudia
authors.initials: AC
authors.lastname: Patrocínio
authors.forename: Afonso Celso Pinto
authors.initials: AC
authors.lastname: Nazário
authors.forename: Angela
authors.initials: A
authors.lastname: Waizberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001707:Biopsy, Needle / Q000592:standards; D001938:Brazil; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D019983:Guideline Adherence; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008485:Medical Audit; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D015397:Program Evaluation; D011786:Quality Control; D019984:Quality Indicators, Health Care / Q000592:standards; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult