Freehand core biopsy of palpable breast lesions: An accurate predictor of tumour grade?

S. A. McIntosh*, L. Panchalingam, S. Payne, I. Miller, T. Sarkar, A. W. Hutcheon, S. D. Heys

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Percutaneous core biopsy (CB) is routinely performed in patients with a cytological diagnosis of breast cancer prior to treatment with primary chemotherapy or mastectomy. This study examined the accuracy of freehand CB in the diagnosis of malignancy and detection of tumour type and grade. Patients treated with neoadjuvant chemotherapy between July 1996 and December 1999 were identified from a prospectively maintained database. Details of patients, core biopsies undertaken, CB histology and final histology following completion of chemotherapy were obtained. CB was performed in 133 consecutive patients. In 19 cases (14%), appearances were reported as "benign" or "normal breast". A single CB showed DCIS only, and the remaining 113 cases were diagnositc of invasive cancer. Tumour type was invasive dustcal carcinoma in 100 cases, invasive lobular carcinoma in 12 cases and "uncertain type" in 1 case. Tumour type on CB was predictive of final histological type in 65% of cases (n=74). In a further 25% of cases (n=28) it was not possible to type the tumour due to insufficient residual disease in the resected specimen. Core biopsy incorrectly predicted tumour type in 10% of cases (n=11). In the 77 cases where there was sufficient residual tumour to allow grading, the CB grade correctly predicted final grade in 91% of cases. Freehand CB of palpable breast lesions has a significant false negative rate in this series. CB allows prediction of tumour grade in 91% and tumour type in 90% of patients. It is possible that the false negative rate may be reduced by performing CB under image guidance.

Original languageEnglish
Number of pages1
JournalBreast Cancer Research and Treatment
Issue number3
Publication statusPublished - 01 Dec 2001
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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