| Objective: The purpose of this study was to comparing and analyzing the diagnosis results of ultrasound-guided vacuum assisted biopsy(MMT)and core needle biopsy(CNB)for breast cancer patients,the diagnostic compliance rate,sensitivity,underestimation rate,missed diagnosis rate,biopsy sampling success rate,immunohistochemistry detection rate and immunohistochemistry consistency rate of two biopsy methods were analyzed and to explore the diagnostic value of two biopsies in patients with breast cancer and the factors leading to the failure of biopsies.Methods: This study included 1008 breast cancer patients who underwent CNB or MMT biopsy at the First Affiliated Hospital of Guangxi Medical University from May 2012 to August 2016.According to the biopsy method group: CNB group,MMT group;according to the maximum diameter(D)of the lesion subgroup: D ≤ 2cm group,2cm < D ≤ 5cm group,D > 5cm group.Clinical data were collected: general clinical data,biopsy and postoperative specimen pathological diagnosis and immunohistochemical information(Such as ER,PR,HER-2,Ki67).The consistency of pathological diagnosis andimmunohistochemical information(Such as ER,PR,HER-2,Ki67)with postoperative specimens were calculated.The difference between the two groups in the diagnostic coincidence rate,underestimation rate,missed diagnosis rate,biopsy sampling success rate,immunohistochemistry detection rate,and ER,PR,HER-2,Ki67 consistency were analyzing.Using SPSS21.0 software for statistical analysis,p <0.05 considered the difference was statistically significant.Results: 1.There were 499 cases in CNB group and 509 cases in MMT group.The 41-50 years old group accounted for the largest proportion in both biopsy groups,which was consistent with the current age of epidemiology of breast cancer.There was no significant difference in the age distribution between the two groups(p=0.663);There was no significant difference in lesion location and mammary gland calcification rate between the two groups(p>0.05);There was a statistically significant difference in menstrual status and maximum diameter between the two groups(p<0.05);2.The total coincidence rate of CNB group,MMT group and postoperative pathological diagnosis was 94.1%,97.9%,the difference was statistically significant(p=0.001);The coincidence rate of MMT group for D ≤ 2cm lesion was higher than that of CNB group(CNB group:93.68%;MMT group: 98.36%,p=0.021);The coincidence rate of MMT group for lesion of 2<D≤5cm was higher than that of CNB group(CNB group: 94.35%;MMT group: 98.40%,p=0.011)The coincidence rates of the two groups for lesion larger than 5 cm were basically the same(CNB group: 93.33%;MMT group: 93.75%,p=0.718).The biopsy sampling success rate of the MMT group was higher than that of the CNB group(CNB group: 95.2%;MMT group: 100%,p=0.001);The histological underestimation rate of the MMT group was lower than that of the CNB group(CNB group: 5.3%;MMT group: 1.8%,p=0.003);The missed diagnosis rate of the MMT group was lower than that of the CNB group(CNB group: 0.6%;MMT group: 0%,p=0.112);3.There was a correlation between histologic underestimation and breast mammography calcification(p=0.035)in CNB group,but there was no correlation between the failure of biopsy sampling in CNB group and breast mammography calcification(p=0.688),and there was no correlation between histologic underestimation and breast mammography calcification(p=1)in MMT group.The biopsy sampling failure,histological underestimation,and missed diagnosis in CNB group were correlated with the immunochemistry could not be detected in CNB specimens(p<0.05).The histological underestimation of MMT group was also related to immunochemistry could not be detected in MMT specimens(p=0.01);4.The detection rate of immunohistochemistry in MMT group was significantly higher than that in CNB group(MMT group: 94.7%;CNB group: 64.5%,p=0.001);The consistency rate of ER,PR,HER-2,Ki67 in MMT group and CNB group was basically the same.(MMT group: 95.6%,91.1%,82.2%,75.5%;CNB group:89.5%,89.5%,77.2%,86%,p>0.05).In most cases(CNB group: 75%;MMT group: 73%),the inconsistency between Ki67 and postoperative results in both groups was due to the transformation of Ki67 into a state of high expression after operation.Conclusion: 1.Both mammotome vacuum assisted biopsy(MMT)and core needle biopsy(CNB)can be used for ultrasound-explorable or clinically accessible breast lesion biopsy.For lesions less than 5 cm in diameter,MMT is a more The ideal biopsy method;2.CNB is more prone to histological underestimation and biopsy sampling failure than MMT,and is associated with calcification in breast lesions and biopsy specimens cannot detect immunohistochemistry;3.Two biopsy methods have basically the sameimmunohistochemistry Detection accuracy,but the immunohistochemical detection ability of MMT is significantly higher than CNB,which is more suitable for guiding the diagnosis and treatment of breast cancer patients;4.Ki67 of some patients undergoing CNB and MMT biopsy changes to high expression after operation.Surgical specimens can be tested again if Ki67 is used to develop a chemotherapy regimen. |
PDF Full Text Request