In 2012 in the United States, there were 230,000 new cases of breast cancer, 99% of them in women, with nearly 40,000 disease-specific deaths (1). A much larger number of lesions were detected on clinical and radiographic breast examinations, and many of these were sufficiently suspicious of cancer to result in a biopsy. Ultimately, it is the responsibility of the pathologist to distinguish those of the biopsied lesions, which require additional attention or treatment from those which do not. In addition, the pathologist must integrate and disseminate an increasingly complex set of pathology-derived data to radiologists, surgeons, and medical and radiation oncologists to achieve optimal clinical results.
Apparently, calcifications are often seen in mammograms and are often an indicator of cancer cells. This paragraph describes core needle biopsy and fine needle biopsy.
NEEDLE BIOPSY
Core needle biopsy (CNB) has the advantage over fine-needle aspiration (FNA) of allowing identification of benign entities and localization of calcium deposits with the result that the proportion of indeterminate and inadequate specimens is far less. Distinction between in situ and invasive carcinoma may also be more readily accomplished, and predictive markers (estrogen receptor [ER], progesterone receptor [PR], HER2/neu, etc.) can be better evaluated. However, FNA may be done more quickly with a diagnosis of malignancy at the time of outpatient visit. In the evaluation of CNB, problems are encountered because of the limited size of the specimens and, not infrequently, the presence of crush artifact. Other problems include potential destruction of lesional tissue by hemorrhage or infarction and displacement of benign epithelium to simulate invasive carcinoma (3), although displacement of epithelium has also been reported following localization by guide-wire for excision of a mammographic abnormality (4). CNB of nonpalpable lesions requires radiographic guidance by either ultrasonography or stereotactic mammography. In CNB performed to evaluate microcalcification, it is important that the calcifications be identified on specimen radiographs (5) and confirmed in the histologic sections, even though calcifications imaged on radiographs are often larger than those seen histologically. Calcification is rarely seen in FNA. Uncertainty in the interpretation of a CNB or the finding of significant atypia should lead to open biopsy. In patients receiving neoadjuvant therapy, CNB specimens may be the only histologic evidence of cancer if there is a complete response.
And much more... to keep reading, go to the site: http://basicmedicalkey.com/breast-4/
