Abstract
Background: Tru-cut needle biopsies form an integral part of Triple assessment of breast cancer and include clinical assessment, mammography and core needle biopsy. No study has been done to evaluate the validity of the procedure in our environment. This study was done to evaluate the validity of core needle biopsies in our centre.
Method: A retrospective study of patients with tru-cut needle biopsies of breast lumps and follow-up excisional biopsy or mastectomy done in the Department of Surgery, University College Hospital, Ibadan over a ten year period was done. Fifty one patients who fulfilled the inclusion criteria had their records obtained from the Department of Pathology. The diagnosis was classified into benign and malignant with the excisional biopsy or mastectomy diagnosis used as the gold standard. The sensitivity, specificity and accuracy were calculated and kappa was also done to evaluate the degree of agreement.
Results: A total of 51 cases were included in this study. The average age of the patients was 47±13years with a range from 19 to 81years. Thirty of the biopsies (59%) had a definitive diagnosis of malignancy while twenty one (41%) were benign. The overall sensitivity, specificity and accuracy were 86%, 71% and 80.4% respectively. The specificity of malignant biopsies was 68% while benign was 35%. The level of agreement for malignant biopsies was higher than benign biopsies with a kappa of 0.39 for malignant diagnosis as against 0.29 for benign.
Conclusion: Tru-cut needle biopsies have a comparable sensitivity and specificity to excisional biopsies. Diagnostic accuracy can be further enhanced with the adoption of image guided biopsies.
Keywords: Tru-cut, biopsy, breast lumps, mastectomy.
Résumé
Contexte: Les biopsies à l’aiguille ‘Tru-cut’ font partie intégrale de la Triple évaluation du cancer de sein et comprennent l’évaluation clinique, la mammographie et biopsie à l’aiguille centrale. Aucune étude n’a été effectuée pour évaluer la validité de la procédure dans notre environnement. Cette étude a été réalisée pour évaluer la validité des biopsies à l’aiguille centrale dans notre centre.
Méthode: Une étude rétrospective de patients avec biopsies à l’aiguille ‘Tru-cut’ de masses de sein et suivi de biopsie chirurgicale ou mastectomie fait dans le département de chirurgie, Centre Hospitalier Universitaire, Ibadan sur une période de dix ans a été faite. Cinquante et un patients qui répondaient aux critères d’inclusion ont eu leurs dossiers obtenus auprès du Département de pathologie. Le diagnostic a été classé en diagnostic bénigne et maligne avec biopsie chirurgicale ou mastectomie utilisé comme étalon d’or. La sensibilité, la spécificité et la précision ont été calculées et kappa a également été fait pour évaluer le degré d’accord.
Résultats: Un total de 51 cas ont été inclus dans cette étude. L’âge moyen des patients était de 47 ± 13 ans avec un rang de 19 à 81 ans. Trente des biopsies (59%) avaient un diagnostic définitif de tumeur maligne tandis que vingt et un (41%) étaient bénignes. La sensibilité totale, spécificité et précision étaient de 86%, 71% et 80,4% respectivement. La spécificité de tumeurs malignes était de 68%, tandis que 35% était bénigne. Le niveau d’accord pour les biopsies malignes était plus élevé que celui des biopsies bénignes avec un kappa de 0,39 pour le diagnostic maligne contre 0,29 pour bénigne.
Conclusion: Les biopsies à l’aiguille ‘Tru-cut’ ont une sensibilité et spécificité comparable aux celles des biopsies chirurgicales. La précision du diagnostic peut être encore améliorée avec l’adoption de biopsies guidées par image.
Mots-clés: ‘Tru-cut’, Biopsie, Tumeur de sein, Mastectomie.
Correspondence: Dr. Ayodeji Salami, Department of Pathology, College of Medicine, University of Ibadan, Nigeria. Email: ayodejisalami@gmail.com
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