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Deng L, Wang T, Yangzhang, Zhai Z, Tao W, Li J, Zhao Y, Luo S, Xu J. Evaluation of large language models in breast cancer clinical scenarios: a comparative analysis based on ChatGPT-3.5, ChatGPT-4.0, and Claude2. Int J Surg 2024; 110:1941-1950. [PMID: 38668655 PMCID: PMC11019981 DOI: 10.1097/js9.0000000000001066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/23/2023] [Indexed: 04/29/2024]
Abstract
BACKGROUND Large language models (LLMs) have garnered significant attention in the AI domain owing to their exemplary context recognition and response capabilities. However, the potential of LLMs in specific clinical scenarios, particularly in breast cancer diagnosis, treatment, and care, has not been fully explored. This study aimed to compare the performances of three major LLMs in the clinical context of breast cancer. METHODS In this study, clinical scenarios designed specifically for breast cancer were segmented into five pivotal domains (nine cases): assessment and diagnosis, treatment decision-making, postoperative care, psychosocial support, and prognosis and rehabilitation. The LLMs were used to generate feedback for various queries related to these domains. For each scenario, a panel of five breast cancer specialists, each with over a decade of experience, evaluated the feedback from LLMs. They assessed feedback concerning LLMs in terms of their quality, relevance, and applicability. RESULTS There was a moderate level of agreement among the raters (Fleiss' kappa=0.345, P<0.05). Comparing the performance of different models regarding response length, GPT-4.0 and GPT-3.5 provided relatively longer feedback than Claude2. Furthermore, across the nine case analyses, GPT-4.0 significantly outperformed the other two models in average quality, relevance, and applicability. Within the five clinical areas, GPT-4.0 markedly surpassed GPT-3.5 in the quality of the other four areas and scored higher than Claude2 in tasks related to psychosocial support and treatment decision-making. CONCLUSION This study revealed that in the realm of clinical applications for breast cancer, GPT-4.0 showcases not only superiority in terms of quality and relevance but also demonstrates exceptional capability in applicability, especially when compared to GPT-3.5. Relative to Claude2, GPT-4.0 holds advantages in specific domains. With the expanding use of LLMs in the clinical field, ongoing optimization and rigorous accuracy assessments are paramount.
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Affiliation(s)
- Linfang Deng
- Department of Nursing, Jinzhou Medical University, Jinzhou
| | | | - Yangzhang
- Department of Breast Surgery, Xingtai People’s Hospital of Hebei Medical University, Xingtai, Hebei, People’s Republic of China
| | - Zhenhua Zhai
- Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou
| | - Wei Tao
- Department of Breast Surgery
| | | | - Yi Zhao
- Department of Breast Surgery
| | - Shaoting Luo
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang
| | - Jinjiang Xu
- Department of Health Management Center, The First Hospital of Jinzhou Medical University, Jinzhou, Liaoning
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Xing B, Chen X, Wang Y, Li S, Liang YK, Wang D. Evaluating breast ultrasound S-detect image analysis for small focal breast lesions. Front Oncol 2022; 12:1030624. [PMID: 36582786 PMCID: PMC9792476 DOI: 10.3389/fonc.2022.1030624] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
Background S-Detect is a computer-assisted, artificial intelligence-based system of image analysis that has been integrated into the software of ultrasound (US) equipment and has the capacity to independently differentiate between benign and malignant focal breast lesions. Since the revision and upgrade in both the breast imaging-reporting and data system (BI-RADS) US lexicon and the S-Detect software in 2013, evidence that supports improved accuracy and specificity of radiologists' assessment of breast lesions has accumulated. However, such assessment using S-Detect technology to distinguish malignant from breast lesions with a diameter no greater than 2 cm requires further investigation. Methods The US images of focal breast lesions from 295 patients in our hospital from January 2019 to June 2022 were collected. The BI-RADS data were evaluated by the embedded program and as manually modified prior to the determination of a pathological diagnosis. The receiver operator characteristic (ROC) curves were constructed to compare the diagnostic accuracy between the assessments of the conventional US images, the S-Detect classification, and the combination of the two. Results There were 326 lesions identified in 295 patients, of which pathological confirmation demonstrated that 239 were benign and 87 were malignant. The sensitivity, specificity, and accuracy of the conventional imaging group were 75.86%, 93.31%, and 88.65%. The sensitivity, specificity, and accuracy of the S-Detect classification group were 87.36%, 88.28%, and 88.04%, respectively. The assessment of the amended combination of S-Detect with US image analysis (Co-Detect group) was improved with a sensitivity, specificity, and accuracy of 90.80%, 94.56%, and 93.56%, respectively. The diagnostic accuracy of the conventional US group, the S-Detect group, and the Co-Detect group using area under curves was 0.85, 0.88 and 0.93, respectively. The Co-Detect group had a better diagnostic efficiency compared with the conventional US group (Z = 3.882, p = 0.0001) and the S-Detect group (Z = 3.861, p = 0.0001). There was no significant difference in distinguishing benign from malignant small breast lesions when comparing conventional US and S-Detect techniques. Conclusions The addition of S-Detect technology to conventional US imaging provided a novel and feasible method to differentiate benign from malignant small breast nodules.
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Affiliation(s)
- Boyuan Xing
- Department of Ultrasound Imaging, The People’s Hospital of China Three Gorges University/the First People’s Hospital of Yichang, Yichang, Hubei, China
| | - Xiangyi Chen
- Department of Nuclear Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yalin Wang
- Department of Medical Engineering, Medical Supplies Center of PLA General Hospital, Beijing, China
| | - Shuang Li
- Department of Pathology, The People’s Hospital of China Three Gorges University/the First People’s Hospital of Yichang, Yichang, Hubei, China
| | - Ying-Kui Liang
- Department of Nuclear Medicine, The Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China,*Correspondence: Dawei Wang, ; Ying-Kui Liang,
| | - Dawei Wang
- Department of Medical Engineering, Medical Supplies Center of PLA General Hospital, Beijing, China,Department of Nuclear Medicine, The Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China,*Correspondence: Dawei Wang, ; Ying-Kui Liang,
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Song RF, Jiang YX, Cui JC, Yu XW, Gao Y, Li L, Pei XH. Horizontal Rotary Cutting Technique for Skin Injury Avoidance in Superficial Benign Breast Masses. Int J Gen Med 2021; 14:1379-1387. [PMID: 33907442 PMCID: PMC8064672 DOI: 10.2147/ijgm.s303183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022] Open
Abstract
Objective This study aims to investigate the feasibility of the horizontal rotary-cut technique in the removal of superficial benign breast tumors with a ≤1.0 cm distance between the upper margin of the tumor and the skin. Patients and Methods A total of 69 patients with superficial benign breast tumors received horizontal rotary-cut surgery between July 2018 and June 2019 (horizontal group). The rotary cutter groove was in the true lateral position of the tumor and the ultrasonic probe was vertical to the rotary cutter groove. The patients were compared with 33 patients who underwent the traditional vertical rotary-cut surgery between July 2017 and June 2018 (traditional group) regarding the aspects of operation time, intraoperative bleeding volume, postoperative skin ecchymosis, skin damage, and tumor residue. The rotary cutter groove was directly below the tumor and the ultrasonic probe was parallel to the rotary cutter groove in the traditional vertical rotary-cut surgery. Results The operation time in the horizontal group was significantly shorter than in the traditional group (7.7 ± 1.1 minutes vs 9.5 ± 1.3 minutes, with t = -7.458 and p = 0.000) and there was significantly less skin damage in the horizontal group than in the traditional group (0 cases vs 3 cases, with p = 0.032). The differences in intraoperative bleeding and postoperative skin ecchymosis between the two groups were not statistically significant (6.0 ± 1.3 mL vs 6.5 ± 1.5 mL, with t = -1.853 and p = 0.067; 4 cases vs 2 cases, with χ 2 = 0.003 and p = 0.958). Ninety-seven patients attended follow-ups for 6-30 (16.5 ± 4.5) months. No residues or recurrences were observed under ultrasound reviews in either group. Conclusion In superficial benign breast tumor removal, the horizontal rotary-cut breast technique can help avoid skin injury, shorten the operation time, and reduce tumor residue more effectively compared with the traditional vertical rotary-cut technique. It has certain popularization and application values.
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Affiliation(s)
- Ren-Feng Song
- Department of General Surgery, The First People's Hospital of Huangzhong District, Xining, 811600, People's Republic of China
| | - Yu-Xia Jiang
- Department of Thyroid and Breast Surgery, The Chinese Medicine Hospital of Shexian, Handan, 056400, People's Republic of China
| | - Jian-Chun Cui
- Department of Thyroid and Breast Surgery, People's Hospital of China Medical University (Liaoning Provincial People's Hospital), Shenyang, 110015, People's Republic of China
| | - Xue-Wei Yu
- Department of General Surgery, The First People's Hospital of Huangzhong District, Xining, 811600, People's Republic of China
| | - Yang Gao
- Department of Thyroid and Breast Surgery, People's Hospital of China Medical University (Liaoning Provincial People's Hospital), Shenyang, 110015, People's Republic of China
| | - Li Li
- Department of Thyroid and Breast Surgery, People's Hospital of China Medical University (Liaoning Provincial People's Hospital), Shenyang, 110015, People's Republic of China
| | - Xiao-Hua Pei
- Department of General Surgery, Xiamen Hospital of Beijing University of Traditional Chinese Medicine, Xiamen, 361001, People's Republic of China
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Nicosia L, Bozzini A, Addante F, Renne G, Latronico A, Meneghetti L, Pala O, Frassoni S, Bagnardi V, Cassano E, Mastropasqua MG. Wireless ultrasound-guided vacuum-assisted breast biopsy: Experience in clinical practice at European Institute of Oncology. Breast J 2021; 27:514-520. [PMID: 33677844 DOI: 10.1111/tbj.14216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 01/04/2023]
Abstract
In the last few years, ultrasound-guided vacuum-assisted breast biopsy (US-VABB) has replaced surgical biopsy due to higher diagnostic accuracy and lower patient discomfort, and, at present, an even greater possibility is represented by the new wireless ultrasound-guided VAB device (Wi-UVAB). The purpose of our study is to determine the diagnostic accuracy of this new device in a sizeable representative number of patients. From January 2014 to June 2018, 168 biopsies were performed in our institution using the new Wi-UVAB device. We analyzed sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of biopsies obtained with the new device using surgical results as reference point, following patients for at least one year. In our cohort, we obtained a complete sensitivity of 97.5%, an absolute sensitivity of 94.3%, a complete specificity of 98%, and an absolute specificity of 98%. The positive predictive value of the procedure was 97.5% while the negative predictive value was 98%. The diagnostic accuracy was 98%. The Wi-UVAB is a safe procedure with high diagnostic accuracy, comparable to that of the traditional vacuum-assisted breast biopsy and even higher than that of core needle biopsy (CNB). Moreover, the Wi-UVAB is easy to use and shows low costs as core needle biopsy (CNB).
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Affiliation(s)
- Luca Nicosia
- Department of Breast Radiology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Anna Bozzini
- Department of Breast Radiology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Francesca Addante
- Department of Emergency and Organs Transplantation, Section of Anatomic Pathology, School of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Giuseppe Renne
- Division of Pathology and Laboratory Medicine, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Antuono Latronico
- Department of Breast Radiology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Lorenza Meneghetti
- Department of Breast Radiology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Oriana Pala
- Division of Pathology and Laboratory Medicine, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Samuele Frassoni
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Enrico Cassano
- Department of Breast Radiology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Mauro Giuseppe Mastropasqua
- Department of Emergency and Organs Transplantation, Section of Anatomic Pathology, School of Medicine, University of Bari "Aldo Moro", Bari, Italy
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de Cursi JAT, Marques MEA, de Assis Cunha Castro CAC, Schmitt FC, Soares CT. Fine-Needle Aspiration Cytology (FNAC) is a reliable diagnostic tool for small breast lesions (≤ 1.0 cm): a 20-year retrospective study. SURGICAL AND EXPERIMENTAL PATHOLOGY 2020. [DOI: 10.1186/s42047-020-00081-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background
Breast cancer is a major public health problem worldwide. It is recommended that small breast lesions or those suspicious for malignancy be evaluated via histopathological examination (“core biopsy” or surgical specimens), and lesions that are probably benign and palpable should be examined via fine-needle aspiration cytology (FNAC). This study aimed to assess the accuracy of FNAC for the diagnosis of small breast lesions.
Methods
We reviewed all anatomopathological reports of FNACs collected between January 1, 2000 and December 31, 2019 (n = 24,721) in a private community pathology service. Lesions up to 1.0 cm (≤1.0 cm) (n = 8334) were included for evaluation and classified according to the recommendation of the International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology in the following categories: (1) insufficient/inadequate; (2) benign; (3) atypical, probably benign; (4) suspicious of malignancy; and (5) malignant. Subsequently, the results of the FNACs were compared to those of the respective histopathological examinations (n = 785).
Results
FNAC had a specificity of 99.6%; sensitivity, 97.4%; positive predictive value, 99.6%; negative predictive value, 97.6%; and accuracy, 98.5%.
Conclusions
FNAC is a reliable method for diagnosing small breast lesions (≤1.0 cm).
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La Forgia D, Fausto A, Gatta G, Di Grezia G, Faggian A, Fanizzi A, Cutrignelli D, Dentamaro R, Didonna V, Lorusso V, Massafra R, Tangaro S, Mazzei MA. Elite VABB 13G: A New Ultrasound-Guided Wireless Biopsy System for Breast Lesions. Technical Characteristics and Comparison with Respect to Traditional Core-Biopsy 14-16G Systems. Diagnostics (Basel) 2020; 10:diagnostics10050291. [PMID: 32397505 PMCID: PMC7277965 DOI: 10.3390/diagnostics10050291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 02/07/2023] Open
Abstract
The typification of breast lumps with fine-needle biopsies is often affected by inconclusive results that extend diagnostic time. Many breast centers have progressively substituted cytology with micro-histology. The aim of this study is to assess the performance of a 13G-needle biopsy using cable-free vacuum-assisted breast biopsy (VABB) technology. Two of our operators carried out 200 micro-histological biopsies using the Elite 13G-needle VABB and 1314 14–16G-needle core biopsies (CBs) on BI-RADS 3, 4, and 5 lesions. Thirty-one of the procedures were repeated following CB, eighteen following cytological biopsy, and three after undergoing both procedures. The VABB Elite procedure showed high diagnostic performance with an accuracy of 94.00%, a sensitivity of 92.30%, and a specificity of 100%, while the diagnostic underestimation was 11.00%, all significantly comparable to of the CB procedure. The VABB Elite 13G system has been shown to be a simple, rapid, reliable, and well-tolerated biopsy procedure, without any significant complications and with a diagnostic performance comparable to traditional CB procedures. The histological class change in an extremely high number of samples would suggest the use of this procedure as a second-line biopsy for suspect cases or those with indeterminate cyto-histological results.
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Affiliation(s)
- Daniele La Forgia
- Radiodiagnostica Senologica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy; (D.L.F.); (R.D.)
| | - Alfonso Fausto
- Dipartimento di Diagnostica per Immagini, Azienda Ospedaliera Universitaria Senese, Viale Bracci 10, 53100 Siena, Italy; (A.F.); (M.A.M.)
| | - Gianluca Gatta
- Dipartimento Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Piazza L. Miraglia 2, 80138 Napoli, Italy;
| | - Graziella Di Grezia
- Dipartimento dei Servizi—Diagnostica per Immagini, Ospedale “G. Criscuoli”, Via Quadrivio, 83054 Avellino, Italy;
| | - Angela Faggian
- UOC Diagnostica per Immagini, Azienda Ospedaliera San Pio, Via dell’Angelo 1, 82100 Benevento, Italy;
| | - Annarita Fanizzi
- Oncologia Medica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy;
- Correspondence: ; Tel.: +39-080-5555111
| | - Daniela Cutrignelli
- Chirurgia Plastica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy;
| | - Rosalba Dentamaro
- Radiodiagnostica Senologica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy; (D.L.F.); (R.D.)
| | - Vittorio Didonna
- Fisica Medica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy; (V.D.); (R.M.)
| | - Vito Lorusso
- Oncologia Medica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy;
| | - Raffaella Massafra
- Fisica Medica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy; (V.D.); (R.M.)
| | - Sabina Tangaro
- Dipartimento di Scienze del Suolo, della Pianta e degli Alimenti, Università degli Studi di Bari ‘Aldo Moro’, 70125 Bari, Italy;
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Via Giovanni Amendola, 165/a, 70126 Bari, Italy
| | - Maria Antonietta Mazzei
- Dipartimento di Diagnostica per Immagini, Azienda Ospedaliera Universitaria Senese, Viale Bracci 10, 53100 Siena, Italy; (A.F.); (M.A.M.)
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Ultrasound-Guided Breast Biopsy: Improved Accuracy of 10-G Cable-Free Elite Compared With 14-G CCNB. J Surg Res 2019; 247:172-179. [PMID: 31761441 DOI: 10.1016/j.jss.2019.10.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/10/2019] [Accepted: 10/16/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Imaging-guided breast biopsy is crucial for breast lesion evaluation. We aim to make the first comprehensive comparison of two different ultrasound-guided breast biopsy devices: 14-G conventional core needle biopsy (CCNB) and the newly applied cable-free, low-vacuum-assisted 10-G breast biopsy system, Elite. METHODS We retrospectively collected patients with suspected breast cancer who underwent ultrasound-guided 14-G CCNB or 10-G Elite from October 2013 through March 2018 and compared the biopsy result with the result after operation. We analyzed the test performance of the two methods and their accuracy in immunohistochemistry assays mainly including estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki67. We also analyzed the accuracy of 10-G Elite with frozen sections. RESULTS Six hundred seventy-four patients who underwent 14-G CCNB and 592 patients who underwent 10-G Elite were finally included in the research. Negative predictive value with Elite was higher than with CCNB (Elite 86.5%, CCNB 41.7%, P < 0.001). Sensitivity (Elite 97.7%, CCNB 96.2%, P = 0.1), specificity (Elite 98.7%, CCNB 90.0%, P = 0.1), positive predictive value (Elite 99.8%, CCNB 99.7%, P = 0.7), and false negative rate (Elite 2.3%, CCNB 3.8%, P = 0.1) showed no difference between two devices. In terms of immunohistochemistry assay, Ki67 agreement of Elite was higher than that of CCNB (Elite 79.5%, CCNB 73.4%, P = 0.045). Estrogen receptor agreement (Elite 90.6%, CCNB 87.7%, P = 0.2), progesterone receptor agreement (Elite 83.9%, CCNB 80.9%, P = 0.3), and human epidermal growth factor receptor two agreement (Elite 94.2%, CCNB 93.5%, P = 0.7) showed no difference between Elite and CCNB. The rate of an inconclusive biopsy result was lower with Elite than with CCNB (Elite 1.5%, CCNB 3.3%, P = 0.045). CONCLUSIONS 10-G Elite has higher negative predictive value, higher Ki67 agreement, and lower inconclusive results than 14-G CCNB. Elite can be a reliable substitute for 14-G CCNB.
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Nakano S, Imawari Y, Mibu A, Otsuka M, Oinuma T. Differentiating vacuum-assisted breast biopsy from core needle biopsy: Is it necessary? Br J Radiol 2018; 91:20180250. [PMID: 29975150 DOI: 10.1259/bjr.20180250] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Needle biopsy has replaced excisional biopsy as a definitive diagnostic technique for breast tumours, although excisional biopsy is still used for complete tumour removal for therapeutic and/or diagnostic purposes. Many vacuum-assisted breast biopsy (VAB) systems have been made available by several manufacturers since the release of the Mammotome (MMT) by Johnson & Johnson in 1995. Several recent discussions have been conducted to identify whether core needle biopsy (CNB) or VAB, is more appropriate. However, currently available VAB systems differ from the conventional system (i.e. articulate arm type 11-gauge(G) MMT), and the characteristics of both CNB and VAB have been improved. In CNB, a 14-G needle is frequently used to obtain a larger sample. By contrast, VAB is considered easier to perform because it uses a thinner needle and a lighter, non-tethered system. When differentiating CNB from VAB, the type of VAB should also be defined. In this review, we discuss the characteristics of ultrasonography-guided VAB and CNB with a focus on practical issues such as the number of samples and volume of tissue obtained during ultrasonography-guided needle biopsy.
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Affiliation(s)
- Satoko Nakano
- 1 Department of Breast Surgery, Kawaguchi Municipal Medical Center , Kawaguchi , Japan
| | - Yoshimi Imawari
- 1 Department of Breast Surgery, Kawaguchi Municipal Medical Center , Kawaguchi , Japan
| | - Akemi Mibu
- 1 Department of Breast Surgery, Kawaguchi Municipal Medical Center , Kawaguchi , Japan
| | - Masahiko Otsuka
- 2 Department of Surgery, Kawaguchi Municipal Medical Center , Kawaguchi , Japan
| | - Toshinori Oinuma
- 3 Department of Pathology, Kawaguchi Municipal Medical Center , Kawaguchi , Japan
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Liu S, Zou JL, Zhou FL, Fang YM. [Efficacy of ultrasound-guided vacuum-assisted Mammotome excision for management of benign breast diseases: analysis of 1267 cases]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1121-1125. [PMID: 28801296 PMCID: PMC6765730 DOI: 10.3969/j.issn.1673-4254.2017.08.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the clinical value of ultrasound-guided vacuum-assisted Mammotome (MMT) system for surgical resection of benign breast disease. METHODS This retrospective study was conducted among 1267 patients who underwent minimally invasive surgery with ultrasound-guided MMT system for benign breast disease at our center between January, 2009 and January, 2014. The resection rate, incidence of complication, recurrence rate, patients' satisfaction, clinical follow-up results and risk factors were analyzed. The patients were followed up at 1 month, 6 months and every 6 months thereafter for up to 2 years with a median follow-up of 22 months. RESULTS Of the total of 1267 patients, 1259 (99.36%) had complete resection of the breast lesions, and residual lesions were found in 8 cases 1 month after the operation. The resection rate was significantly associated with lesion size (P=0.003) but not with the patients'age, pathology, BI-RADS classification, or the number or location of the lesions (P>0.05). Eighty-nine (7.02%) patients showed postoperative complications, and hematoma occurred in 70 (5.52%) patients after the operation. The complication rate was significantly associated with the number and location of lesions (P=0.000) but not with age, pathology, BI-RADS classification or the lesion size (P>0.05). A total of 193 (15.23%) patients had recurrence after the operation, including 65 (5.13%) with in situ recurrence and 128 (10.1%) with new lesions. The recurrence rate was significantly associated with the number and size of lesions (P=0.000) but not with age, pathology, BI-RADS classification or location of lesions(P>0.05). Six patients were not satisfied with the appearance of the incision, and the overall satisfaction rate of the patients was 99.52%. CONCLUSION s Ultrasound-guided vacuum-assisted MMT excision is a safe and effective procedure for benign breast disease with a low surgical complication rate, a high resection rate and a low recurrence rate. This technique results in good postoperative appearance for treatment of benign and high-risk breast lesions, especially multiple benign breast lesions.
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Affiliation(s)
- Shu Liu
- Department of Breast Surgery, Guiyang Maternal and Child Healthcare Hospital/Guiyang Minimally Invasive Breast Center, Guiyang 550003, China. E-mail:
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A sensitivity and specificity comparison of fine needle aspiration cytology and core needle biopsy in evaluation of suspicious breast lesions: A systematic review and meta-analysis. Breast 2017; 31:157-166. [DOI: 10.1016/j.breast.2016.11.009] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 11/18/2022] Open
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Saha M, Mukherjee R, Chakraborty C. Computer-aided diagnosis of breast cancer using cytological images: A systematic review. Tissue Cell 2016; 48:461-74. [DOI: 10.1016/j.tice.2016.07.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/16/2016] [Accepted: 07/27/2016] [Indexed: 12/13/2022]
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Kocaay AF, Celik SU, Sevim Y, Ozyazici S, Cetinkaya OA, Alic KB. The role of fine needle aspiration cytology and core biopsy in the diagnosis of palpable breast masses. Niger Med J 2016; 57:77-80. [PMID: 27226679 PMCID: PMC4872495 DOI: 10.4103/0300-1652.182078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: The modern approach to palpable breast masses is to get cytopathologic diagnosis before definitive surgery. We aimed to compare fine needle aspiration cytology (FNAC) with core biopsy in histopathologic diagnosis of palpable breast masses. Materials and Methods: Data were collected on 123 women who have suspicious palpable breast masses from 2007 to 2010. Results: Of the 123 patients, core biopsies were performed on 64 patients (Group 1) and FNAC on 59 patients (Group 2). Malignancy was confirmed in 25 out of 32 clinically suspicious patients in Group 1 (78.1%), and 20 out of 21 participants in Group 2 (95.2%). Among the clinically suspicious patients, 81.8% of 33 patients in Group 1, and 90.3% of 31 patients in Group 2 were identified malignancy. Sensitivity was 100% for core biopsy and 95% for FNAC. Specificity was 100% in both procedures. False negativity rate in FNAC were 5%. Conclusion: Sensitivity and specificity showed that in the case of true histopathologic classification, core biopsy is superior to FNAC. Nevertheless, FNAC's role as a fast, simple and cheap diagnosis cannot be ignored. It is an effective diagnostic tool in most patients, in comparison to the correct and specific typing of core biopsies in benign lesions which protect patients from the open biopsy.
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Affiliation(s)
- Akin Firat Kocaay
- Department of General Surgery, School of Medicine, Ankara University, Ankara, Turkey
| | - Suleyman Utku Celik
- Department of General Surgery, School of Medicine, Ankara University, Ankara, Turkey
| | - Yusuf Sevim
- Department of General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Sefa Ozyazici
- Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Omer Arda Cetinkaya
- Department of General Surgery, School of Medicine, Ankara University, Ankara, Turkey
| | - Kamil Bulent Alic
- Department of General Surgery, School of Medicine, Ankara University, Ankara, Turkey
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