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Abstract
Aim. To compare histological findings of multifocal biopsy and vacuum aspiration biopsy (VAB) in breast cancer (BC) patients after neoadjuvant polychemotherapy (nPCT) with complete clinical response (cCR) to select an appropriate method for evaluating complete pathomorphological response in this patient group.
Material and methods. We analyzed 50 stage IA-IIIA BC patients with various molecular-biological subtypes, who exhibited cCR after nPCT. 35 patients underwent multifocal breast biopsy (needle size G12-14), while 15 patients underwent VAB (needle size G7-10), followed by histological examination. The results were compared with the planned morphology of the surgical material.
Results. In the VAB group, the overall method sensitivity was 50.0 % (CI: 15.8-84.2 %); specificity was 100.0 % (CI: 75.3-100 %); false-negative rate (FNR) was 6.7 % (n = 1) (CI: 1.7-21.8 %). The overall diagnostic accuracy of the method was 93.3 % (CI: 78.2-98.3 %). In the multifocal biopsy group, the overall method sensitivity was 16.7 % (CI: 4.3-45.9 %); specificity was 100.0 % (CI: 79.4-100 %); FNR was 23.8 % (n = 5) (CI: 11.3-41.9 %). The overall method diagnostic accuracy was 77.2 % (CI: 59.7-89.3 %). The relatively low sensitivity of the method is attributed to a high frequency of FNR (n = 5, 23.8 %).
Conclusion. The study is ongoing, but based on the current results, preliminary conclusions can be drawn that the VAB method has shown better results compared to multifocal biopsy. The overall diagnostic accuracy of the VAB is 93.3 % (CI: 78.2-98.3 %), while the multifocal biopsy overall diagnostic accuracy is 77.2 % (CI: 59.7-89.3 %). We believe this is due to the larger sample size obtained with VAB, attributed to the larger needle size used. However, to make a final conclusion, it is necessary to continue enrolling patients into the VAB group.
References
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