title: Diagnostic value of fine needle aspiration and core needle biopsy in special types of breast cancer.
abstract: BACKGROUND
  Although fine needle aspiration (FNA) biopsy is an established tool to assess breast lesions, there has been a trend toward using core needle biopsy (CNB) instead. The aim of this study was to compare the diagnostic accuracy of FNA and CNB in special types of breast cancer.
  
  
  METHODS
  A retrospective review of diagnostic results of pre-operatively performed FNA or CNB, or a combination of the two, was conducted. The cases include histologically proven invasive ductal carcinoma of no special type (NST n = 159), invasive lobular carcinoma (ILC n = 65), mucinous carcinoma (MUC n = 51), and apocrine carcinoma (APO n = 25).
  
  
  RESULTS
  The absolute diagnostic sensitivity of FNA to detect malignancy in ILC and APO patients was inferior to that of NST patients (p < 0.001 for ILC and APO). Within each cancer type, the sensitivity of CNB was higher than that of FNA in the ILC and APO patients (p < 0.001 and p < 0.05, respectively). As for NST and MUC patients, FNA and CNB had equivalent sensitivity. The sensitivity of FNA alone significantly improved when combined with CNB in NST, ILC and APO patients (p < 0.05, p < 0.001, and p < 0.05, respectively).
  
  
  CONCLUSIONS
  Our results suggest that FNA has less diagnostic accuracy than CNB for ILC and APO; thus, the use of CNB should be encouraged when these types of cancer are clinically suspected or when the initial FNA is inconclusive.
authors.affiliation: Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. r-ohashi@nms.ac.jp.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ohashi
authors.affiliation: Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Matsubara
authors.affiliation: Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Watarai
authors.affiliation: Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Yanagihara
authors.affiliation: Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.|Department of Diagnostic Pathology, Iida Hospital, Nagano, Japan.
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Tsuchiya
authors.affiliation: Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takei
authors.affiliation: Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.|Department of Pathology and Integrative Oncological Pathology, Nippon Medical School, Tokyo, Japan.
authors.forename: Zenya
authors.initials: Z
authors.lastname: Naito
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Core needle biopsy; Fine needle aspiration; Special type of cancer