BJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Coombs, N J
Right arrow Articles by Briley, M S
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Coombs, N J
Right arrow Articles by Briley, M S
British Journal of Radiology 74 (2001),123-126 © 2001 The British Institute of Radiology

Full paper

Improving the sensitivity of stereotactic core biopsy to diagnose ductal carcinoma in situ of the breast: a mathematical model

N J Coombs, FRCS 1 J R L Laddie, BM 1 G T Royle, FRCS 1 C M Rubin, FRCR 2 and M S Briley, FRCR 3

1 Departments of Breast Surgery 3 Radiology, Royal South Hants Hospital, Southampton 2 Southampton and Salisbury Breast Screening Unit, Southampton, UK

Correspondence: Mr Gavin Royle, Consultant Surgeon, Royal South Hants Hospital, Southampton SO14 0YG, UK

Stereotactic core biopsy (SCB) is performed on mammographically suspicious, non-palpable lesions of the breast. Reported sensitivities of SCB for the detection of ductal carcinoma in situ (DCIS) vary from 41% to 93%. We have developed a simple mathematical model to predict the probability of retrieving at least one diagnostic core from a focus of DCIS. We make recommendations of the number of samples needed for different sized areas of microcalcification. The sensitivity of SCB is affected by needle placement accuracy, diameter of the area of microcalcification (d), histological density of DCIS (x) (calculated as 7.5% by previous studies) and number of core samples (n) removed. The probability of achieving at least one representative core sufficient for diagnosis (P(core)) is defined as:


where {rho} is the probability of a SCB accurately targeting the area of microcalcification. At least seven core samples should be removed in small foci (<5 mm) of DCIS to achieve a 0.75 probability of an accurate diagnosis. The probability of a diagnostic biopsy of larger areas of DCIS (>10 mm) is 0.95 when five cores are removed. This formula serves as an explanation to patients why SCB may fail to diagnose DCIS, and justifies the retrieval of more core samples to increase the probability of an accurate diagnosis and to reduce the chance of a non-representative core. In the absence of sufficient samples, a wire-guided open biopsy is necessary to exclude DCIS.




This article has been cited by other articles:


Home page
 J. Clin. Pathol.Home page
M F Dillon, C M Quinn, E W McDermott, A O'Doherty, N O'Higgins, and A D K Hill
Diagnostic accuracy of core biopsy for ductal carcinoma in situ and its implications for surgical practice.
J. Clin. Pathol., July 1, 2006; 59(7): 740 - 743.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
BJR DMFR IMAGING  ALL BIR JOURNALS 
Copyright © 2001 by the British Institute of Radiology.