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Changing to core biopsy in an NHS breast screening unit
P D Britton1, C D Flower, A H Freeman
1Department of Radiology, Addenbrooke's Hospital and Cambridge University, UK.
Clinical Radiology
|November 20, 1997
Summary
Core biopsy is a safe and accurate method for assessing screen-detected abnormalities, replacing fine needle aspiration cytology. This technique exceeds National Health Service Breast Screening Programme standards, demonstrating high sensitivity and specificity in initial evaluations.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Transition from fine needle aspiration cytology to core biopsy for screen-detected abnormalities.
- Established National Health Service Breast Screening Programme (NHSBSP) standards for evaluation.
Purpose of the Study:
- To evaluate the safety and accuracy of core biopsy in assessing screen-detected breast abnormalities.
- To compare core biopsy performance against NHSBSP target standards.
Main Methods:
- Prospective analysis of 202 core biopsies performed on screen-detected abnormalities.
- Surgical histological confirmation for 111 patients.
- Results analyzed per NHSBSP Publication Number 22 standards.
Main Results:
- Absolute sensitivity: 89.3%, Complete sensitivity: 93.2%, Specificity: 88.7%.
- Positive predictive value for malignancy: 100%. False negative rate: 3.9%.
- 12 biopsies (5.9%) were inadequate for diagnosis.
Conclusions:
- Core biopsy is a safe and accurate substitute for fine needle aspiration cytology.
- Core biopsy performance exceeds NHSBSP target standards, even during the learning phase.
- This method effectively assesses screen-detected abnormalities with high diagnostic yield.