title: Diagnostic performance of core needle biopsy in identifying breast phyllodes tumors.
abstract: BACKGROUND
  A retrospective analysis of diagnoses was performed in patients with phyllodes tumors of the breast (PTB) who received preoperative core needle biopsy (CNB) and had breast surgery at Fudan University Shanghai Cancer Center from January 1, 2002 to April 1, 2013. The resulting data allowed us to compare the accordance between CNB and excision diagnoses of PTB patients and evaluate the accuracy of CNB in preoperative diagnosis.
  
  
  METHODS
  Data from 128 patients with PTB who had undergone preoperative CNB and breast surgery were retrospectively analyzed. We reviewed the medical history, clinical follow-up data, and CNB diagnostic data. A diagnostic test was used to evaluate the sensitivity and specificity of CNB in diagnosing benign, borderline, and malignant phyllodes tumors.
  
  
  RESULTS
  The accuracy of CNB for diagnosing PTB was 13.3% (17/128). Of the remaining patients, 98 (75.5% of the PTB patients) were diagnosed with fibroadenoma or fibroepithelial lesions. The sensitivity of CNB at diagnosing benign, borderline, and malignant phyllodes tumors were 4.9% (2/41), 4.2% (3/71), and 25.0% (4/16), respectively, whereas the corresponding specificity were 92.0%, 98.2%, and 100%, respectively. Some clinical features, such as large tumor size, rapid growth, or surgical history of fibroadenomas, were indicative of an increased possibility of PTB.
  
  
  CONCLUSIONS
  CNB provides a pathological basis for the preoperative diagnosis of PTB, but it has a poor accuracy and offers limited guidance for surgical decisions. Considering CNB along with multiple histologic features may improve the ability to accurately diagnose PTB. An integrated assessment using CNBs in combination with clinical data and imaging features is suggested as a reliable strategy to assist PTB diagnosis.
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China;; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Zhi-Rui
authors.initials: ZR
authors.lastname: Zhou
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China;; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Chen-Chen
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China;; Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
authors.forename: Xiang-Jie
authors.initials: XJ
authors.lastname: Sun
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China;; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Zhao-Zhi
authors.initials: ZZ
authors.lastname: Yang
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China;; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Yu
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China;; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Xiao-Mao
authors.initials: XM
authors.lastname: Guo
keywords: Phyllodes tumors of the breast (PTB); core needle biopsy (CNB); diagnostic accuracy