Changing to core biopsy in an NHS breast screening unit

• Published in: Clinical radiology Vol. 52; no. 10; pp. 764 - 767
• Main Authors: Britton, P.D., Flower, C.D.R., Freeman, A.H., Sinnatamby, R., Warren, R., Goddard, M.J., Wight, D.G.D., Bobrow, L.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 1997; Elsevier
• Subjects: Biological and medical sciences; Biopsy - methods; Biopsy, Needle; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Breast Neoplasms - prevention & control; False Negative Reactions; Female; Genital system. Mammary gland; Humans; Investigative techniques, diagnostic techniques (general aspects); Mammography; Mass Screening; Medical sciences; Predictive Value of Tests; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Sensitivity and Specificity; State Medicine; Ultrasonography, Interventional; Ultrasonography, Mammary; United Kingdom; Human; Evaluation; Instrumentation therapy; Medical screening; Aspiration punction; Female genital diseases; Histopathology; Fine needle; Biopsy; Female; Technique; Mammary gland; Predictive factor; Comparative study
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/S0009-9260(97)80156-0

We recently changed from using fine needle aspiration cytology to using core biopsy exclusively in the assessment of screen detected abnormalities. Two hundred and two biopsies (1% of women screened) were performed. Surgical histological confirmation was obtained in 111 patients (101 malignant and 10 benign). The remaining patients were either returned to standard 3-yearly screening or early repeat screening after 1 year. Analysis of the results was performed in accordance with the standards specified in the National Health Service Breast Screening Programme (NHSBSP) Publication Number 22. Absolute sensitivity was 89.3%, complete sensitivity was 93.2%, specificity (including patients undergoing both surgical excision and follow-up) was 88.7%. The predictive value of a positive (malignant) core biopsy result was 100%. The false negative rate was 3.9%. Twelve (5.9%) biopsies were classified inadequate for diagnosis. Core biopsy is a safe and accurate way of assessing screen detected abnormalities and can be used as a substitute for fine needle aspiration cytology with results that exceed the National Health Service Breast Screening Programme target standards, even in the learning phase.