DIAGNOSTIC VALUE OF CORE NEEDLE BIOPSY IN BREAST CANCER

Cilj istraživanja: CNB je u svijetu priznata metoda na kojoj se temelji početna terapija raka dojke zbog visoke osjetljivosti i specifičnosti u usporedbi s invazivnijom kirurškom metodom. Cilj ovog istraživanja je bio ispitati vrijednost CNB-a u dijagnostici raka dojke na KBC-u Split te usporediti dobivenu specifičnost i osjetljivost s onom u svijetu. Ispitanici i metode: Retrospektivno su prikupljeni podaci nalaza 75 bolesnika koji su imali patohistološki nalaz nakon CNB-a i kirurške ekscizije na KBC-u Split. Za uključiti u studiju bilo je potrebno da se CNB uradila na lokalitetu Firule u periodu od lipnja 2017. do kraja 2018. godine. Skupljanje podataka operacijskih nalaza je trajalo do lipnja 2019. godine. Rezultati: Od ukupno obrađenih 75 bolesnika, nakon CNB je dijagnosticirano 68 bolesnika s malignomom dok je nakon kirurške ekscizije bilo 71. Preostalim bolesnicima su dijagnoze bile benigne lezije. Nadalje, 68 bolesnika je imalo primarni rak dojke dok ostalih troje su imali metastatske lezije u dojci. Izračunom je za CNB dobivena specifičnost od 100%, osjetljivost 95,77%, pozitivna prediktivna vrijednost 100% te negativna prediktivna vrijednost 57,14%. Kod usporedbe rezultata prognostičkih faktora, ER, PR, Her2 te proliferacijskog indeksa Ki-67, nije se pokazala statistički značajna razlika nakon CNB-a s obzirom na kiruršku eksciziju. Zaključci: CNB je metoda izbora za dijagnostiku raka dojke s visokom specifičnosti i osjetljivosti na KBC-u Split, lokalitet Firule, te dobivene vrijednosti se ne razlikuju od svjetskih. Dobiveni rezultat niske negativne prediktivne vrijednosti se razlikuje od one iz literature, a vjerojatno zbog malog broja uzorka benignih lezija.Objectives: Percutaneous CNB is a worldwide recognized method on which initial breast cancer therapy is based due to high sensitivity and specificity as a reliable alternative to more invasive surgical method. The aim of the study was to evaluate the CNB value in breast cancer diagnosis at University hospital of Split, Firule, and compare the obtained specificity and sensitivity to the one in the world. Patients and methods: Retrospective data were collected from 75 patients with histopathology findings after CNB and surgical excision at University hospital of Split. To include in the study, it was necessary that CNB was performed at the Firule in the period from June 2017 till the end of 2018. Collecting the histopathological findings after the surgery lasted until June 2019. Results: Out of the total 75 patients whose findings were collected, 68 patients were diagnosed malignant following the CNB, whereas 71 patients were diagnosed malignant after the surgery. The remaining patients, 7 after CNB and 4 after surgery, were diagnosed with benign lesions. Furthermore, 68 patients had primary breast cancer while the other three had metastatic breast lesions. In this study the CNB showed specificity value of 100%, sensitivity value of 95.77%, positive predictive value of 100% and negative predictive value of 57.14%. When comparing the prognostic factors, ER, PR, Her2, and the proliferation index of Ki-67, there was no statistically significant difference after CNB with regard to surgical excision. Conclusion: CNB is the method of choice for diagnosing breast cancer with high specificity and sensitivity at University hospital, Firule and the obtained values do not differ from the values in the rest of the world. The obtained low negative predictive value is different from the one’s found in the literature and probably due to the few specimens of benign lesions