title: Accuracy of prognostic and predictive markers in core needle breast biopsies compared with excisional specimens.
abstract: BACKGROUND
  Core needle biopsy (CNB) is widely accepted for preoperative diagnosis of breast cancer and sometimes can be the only way of providing a suitable specimen for prognostic and predictive marker studies prior to neoadjuvant treatment. The purpose of this study was to evaluate the accuracy of CNB by comparing histological tumor type and grade as well as estrogen receptor (ER), progesterone receptor (PR), p53, and HER2/ neu status by immunohistochemistry in CNB and excisional surgical specimens.
  
  
  METHODS
  During a 2.5-year study period, we identified 30 patients with breast cancer, who underwent CNB and definitive surgery. To evaluate the accuracy of CNB, tumor grade, ER, PR, HER2, and p53 status were immunohistochemically determined in both the CNB and the surgical specimens, and concordance of results between the 2 specimens was assessed.
  
  
  RESULTS
  The concordance rate was 100% for histological type, 66.6% for histological grade, and 96.7, 90, 76.7 and 93.3% for ER, PR, p53 and HER2/neu, respectively.
  
  
  CONCLUSIONS
  Our study showed that CNB has an excellent accuracy for tumor type, ER, and HER2/ neu; however, it should be used cautiously for tumor grade, PR, and p53 status. Thus, excisional biopsy is recommended for the determination of these factors.
authors.affiliation: Vascular and Endovascular Surgery Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Motamedolshariati
authors.affiliation: Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Memar
authors.affiliation: Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Aliakbaian
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohammad T
authors.initials: MT
authors.lastname: Shakeri
authors.affiliation: Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Samadi
authors.affiliation: Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Jangjoo
keywords: Breast cancer; Core needle biopsy; Prognostic factors