Download or read book Effectiveness of Core needle and Open Surgical Biopsy in Breast Cancer Evaluation written by and published by . This book was released on 2011 with total page 298 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Comparative Effectiveness of Core Needle and Open Surgical Biopsy for the Diagnosis of Breast Lesions written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-05-14 with total page 300 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breast cancer is the second most common malignancy of women. The American Cancer Society estimates that in the U.S. in 2009, 67,280 women will have been diagnosed with new cases of in situ cancer, 192,370 women will have been newly diagnosed as having invasive breast cancer, and there will be 40,170 deaths due to this disease. In the general population, the cumulative risk of being diagnosed with breast cancer by age 70 is estimated to be 6% (lifetime risk of 13%). Ductal carcinoma, including ductal carcinoma in situ (DCIS), is the most common malignancy of the breast. It arises within the ducts of the breast. DCIS is early breast cancer confined to the inside of the ductal system, and invasive (also called infiltrating) ductal carcinoma is a later stage that has broken through the walls of the ducts and invaded nearby tissues. Lobular carcinoma is similar to ductal carcinoma, first arising in the terminal ducts of the lobules and then invading through the walls of the ducts and into nearby tissues. Atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) are caused by abnormal cellular proliferation within the terminal ducts of the lobules. The two conditions are distinguished primarily by the degree to which the ducts are filled by cells. Women diagnosed with ALH or LCIS are at elevated risk of developing an invasive carcinoma in the future. Other types of benign breast abnormalities that have been linked to an elevated risk of invasive carcinoma or a finding of associated invasive carcinoma upon excision are atypical ductal hyperplasia (ADH), papillary lesions, and radial scars. Breast cancer is usually first detected by feeling a lump on physical examination or by observing an abnormality during x-ray screening mammography. Survival rates depend on the stage of disease at diagnosis. At stage 0 (carcinoma in situ) the five-year survival rate is close to 100%. The five-year survival rate for women with stage IV (cancer that has spread beyond the breast) is only 27%. These observations suggest that breast cancer mortality rates can be significantly reduced by identifying cancers at earlier stages. Because early breast cancer is asymptomatic, the only way to detect it is through population-wide screening. Mammography is a widely accepted method for breast cancer screening. Mammography uses x-rays to examine the breast for clusters of microcalcifications, circumscribed and dense masses, masses with indistinct margins, architectural distortion compared with the contralateral breast, or other abnormal structures. The American College of Radiology has created a standardized system for reporting the results of mammography, the Breast Imaging Reporting and Data System (BI-RADS(r) ). There are seven categories of assessment and recommendation: 0 Need additional imaging evaluation and/or prior mammograms for comparison 1 Negative 2 Benign finding 3 Probably benign finding. Initial short interval follow-up suggested 4 Suspicious abnormality. Biopsy should be considered. 5 Highly suggestive of malignancy. Appropriate action should be taken. 6 Known biopsy-proven malignancy. Appropriate action should be taken. This systematic review was commissioned by the Agency for Healthcare Research and Quality (AHRQ) to address the following Key Questions; they include, but are not limited to: 1. In women with a palpable or non-palpable breast abnormality, what is the accuracy of different types of core-needle breast biopsy compared with open biopsy for diagnosis? 2. In women with a palpable or non-palpable breast abnormality, what are the harms associated with core-needle breast biopsy compared to the open biopsy technique in the diagnosis of breast cancer? 3. How do open biopsy and various core-needle techniques differ in terms of patient preference, availability, costs, availability of qualified pathologist interpretations, and other factors that may influence choice of particular technique?

Download or read book Core Needle and Open Surgical Biopsy for Diagnosis of Breast Lesions an Update to the 2009 Report written by Agency for and Quality and published by . This book was released on 2014-11-14 with total page 250 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately one in eight U.S. women will develop breast cancer during her lifetime. Because the earliest stages of breast cancer are asymptomatic, the process of breast cancer diagnosis is often initiated by detecting an abnormality through self-examination, physical examination by a clinician, or screening mammography. If the initial assessment suggests that the abnormality could be breast cancer, the woman is likely to be referred for a biopsy-a sampling of cells or tissue from the suspicious lesion. Three techniques for obtaining samples from suspicious breast lesions are available: fine-needle aspiration, biopsy with a hollow core needle, or open surgical retrieval of tissue. Fine-needle aspiration samples cells and does not assess tissue architecture, is generally considered less sensitive than core needle and open biopsy methods, and is used less frequently. Core-needle biopsy, which retrieves a sample of tissue, and open surgical procedures are the most frequently used biopsy methods. Lesion samples obtained by core needle or surgical biopsy are evaluated by pathologists and classified into histological categories with the primary goal of determining whether the lesion is benign or malignant. Because core needle biopsy samples only part of the breast abnormality, a risk exists that a lesion will be classified as benign, high risk, or noninvasive when invasive cancer is in fact present in unsampled areas. Open surgical biopsy samples most or all of the lesion, and is therefore considered to have a smaller risk of misdiagnosis. However, open procedures may carry a higher risk of complications, such as bleeding or infection, compared to core needle biopsy procedures.5 Therefore, if core needle biopsy is also highly accurate, women and their clinicians may prefer some type of core needle biopsy to open surgical biopsy. In 2009, the ECRI Evidence-based Practice Center conducted a comparative effectiveness review for core needle versus open surgical biopsy commissioned by the Agency for Health Care Research and Quality. That evidence report assessed the diagnostic test performance and adverse events of core needle biopsy techniques compared to open surgical biopsy and evaluated differences between open biopsy and core needle biopsy with regards to patient preferences, costs, availability, and other factors. The authors concluded that core needle biopsies were almost as accurate as open surgical biopsies, had a lower risk of severe complications, and were associated with fewer subsequent surgical procedures. The publication of additional studies and changes in practice raised the concern that the conclusions of the original report may be out of date. New studies may also provide additional information allowing the exploration of heterogeneity for test performance and safety outcomes. Therefore, an updated review of the published literature was considered necessary to synthesize all evidence on currently available methods for core needle and open surgical breast lesion biopsy. We specified the following three Key Questions to guide the conduct of the update: Key Question 1: In women with a palpable or nonpalpable breast abnormality, what is the test performance of different types of core needle breast biopsy compared with open biopsy for diagnosis? Key Question 2: In women with a palpable or nonpalpable breast abnormality, what are the adverse events (harms) associated with different types of core needle breast biopsy compared with open biopsy for diagnosis? Key Question 3: How do open biopsy and various core needle techniques differ in terms of patient preference, availability, costs, availability of qualified pathologist interpretations, and other factors that may influence choice of a particular technique?

Download or read book Core Needle and Open Surgical Biopsy for Diagnosis of Breast Lesions written by Issa J. Dahabreh and published by . This book was released on 2014 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: Core needle biopsy and open surgical biopsy are the most frequently used procedures for diagnosis of suspicious breast lesions. An AHRQ evidence report on the comparative effectiveness and adverse events of breast biopsy methods was completed in 2009. The availability of additional studies and the uncertainties surrounding newer biopsy techniques prompted an update of that report. STUDY ELIGIBILITY CRITERIA: We searched nine electronic databases (last search on December 16, 2013) for English-language full-text reports of prospective or retrospective cohort studies of women not previously diagnosed with breast cancer who were undergoing biopsy for diagnosis of a breast lesion. STUDY APPRAISAL AND SYNTHESIS METHODS: A single investigator extracted quantitative and qualitative data from each study; a second reviewer verified extracted data. We assessed the strength and applicability of the evidence. We performed Bayesian meta-analyses to estimate summary test performance and performed indirect comparisons to assess the relative effectiveness of alternative core needle biopsy methods. Statistical models accounted for between-study heterogeneity. RESULTS: One hundred and sixty studies of moderate to high risk of bias provided information on the test performance of alternative core needle biopsy techniques. We found one new study investigating the test performance of open biopsy. For women at average risk of cancer, both ultrasound- and stereotactically guided biopsies had average sensitivities higher than 0.97 and average specificities ranging from 0.92 to 0.99; freehand biopsy methods had average sensitivity of 0.91 and specificity of 0.98. However, evidence on the test performance of magnetic resonance imaging (MRI)-guided biopsy (6 studies) was insufficient to draw conclusions. Test performance did not differ between women at average and high baseline risk of cancer, but results were imprecise. Test performance of automated and vacuum-assisted devices (when using the same imaging guidance) was fairly similar (absolute differences in sensitivity and specificity d 0.1). One hundred and forty-one studies contributed information on potential harms of different core needle biopsy techniques. Overall, core needle biopsy had a lower risk of complications than open surgical biopsy; however information on the latter was sparse. The absolute incidence of adverse events was low and the incidence of severe complications was less than 1 percent for all techniques. Vacuum-assisted procedures appeared to be associated with increased bleeding and hematoma formation; biopsies performed with patients seated upright appeared to be associated with increased risk of vasovagal reactions. Harms were reported inconsistently, raising concerns about selective outcome reporting. We found 10 case reports of patients developing tumors at the site of prior core needle biopsies. We found information on only a few patient-relevant and resource-related outcomes. Based on 42 studies, core needle biopsy obviated the need for surgical procedures in about 75 percent of women. Meta-analysis of 10 studies reporting the number of surgical procedures required after biopsy suggested that the odds of requiring only one procedure were almost 15 times as high among women receiving core needle biopsy, as compared to those receiving open surgical biopsy. However, this result may be confounded by indication. LIMITATIONS: Patient-level data were unavailable and information about study- or population-level characteristics was too limited to allow the identification of modifiers of test performance, adverse events, or clinical outcomes. Studies reported adverse events incompletely, and did not provide details of their outcome ascertainment methods. CONCLUSIONS: A large body of evidence suggests that ultrasound and stereotactically guided core needle biopsy procedures have sensitivity and specificity close to that of open biopsy procedures, and are associated with fewer adverse events. The strength of the evidence on the test performance of these methods is deemed moderate because studies are at medium to high risk of bias, but provide precise and fairly consistent results. Freehand procedures have lower sensitivity than imaging-guided methods. The strength of evidence on the comparative test performance of automated and vacuum-assisted devices (when using the same imaging guidance) is deemed low, because of concerns about the risk of bias of included studies and the reliance on indirect comparisons. There were insufficient data to draw conclusions for MRI-guided biopsy or women at high baseline risk of cancer. There is low strength of evidence that vacuum-assisted procedures have a higher risk of bleeding than automated methods. There is moderate strength of evidence that women diagnosed with breast cancer by core needle biopsy are more likely to have their cancer treated with a single surgical procedure, compared with women diagnosed by open surgical biopsy.

Download or read book Comparative Effectiveness of Core needle and Open Surgical Biopsy for the Diagnosis of Breast Lesions written by Wendy Bruening and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The large number of possible methods of performing breast biopsy can be bewildering to patients and health care providers alike. Which method should one choose? Is a particular method clearly superior, or does the method of choice depend upon individual patient characteristics? We have performed a systematic review intended to evaluate the accuracy of different methods of performing breast biopsy and to explore what factor(s) may impact the accuracy and possible harms of different methods of performing breast biopsy.

Download or read book Comparative Effectiveness of Core Needle and Open Surgical Biopsy for the Diagnosis of Breast Lesions written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Breast Cytohistology written by Joan Cangiarella and published by Cambridge University Press. This book was released on 2013-09-12 with total page 541 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each volume in this richly illustrated series, published in association with the Papanicolaou Society of Cytopathology, provides an organ-based approach to the cytological and histological diagnosis of small tissue samples. Benign, pre-malignant and malignant entities are presented in a well-organized and standardized format, with high-resolution color photomicrographs, tables, and lists of key specific morphologic criteria. Example vignettes allow the reader to assimilate the diagnostic principles in a case-based format. This volume provides comprehensive coverage of both surgical pathology and cytopathology of breast lesions. With a focus on malignant tumors, the full spectrum of inflammatory disorders, benign lesions, and hyperplasias are also covered in detail. Advantages and disadvantages of aspiration and core biopsy are discussed, as well as ancillary testing such as hormonal and molecular markers. With over 200 printed photomicrographs and a DVD-ROM offering all images in a downloadable format, this is an important resource for all anatomic pathologists.

Download or read book Minimally Invasive Breast Biopsies written by Renzo Brun del Re and published by Springer Science & Business Media. This book was released on 2009-09-17 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt: Modern imaging methods have made it possible to detect breast cancer at an earlier stage than in the past. Nevertheless, a large majority of suspicious findings at screening subsequently prove to be benign. It is therefore important to be able to identify benign lesions in a manner that is reliable, tissue sparing, patient friendly, and cost-effective. More than 70% of breast biopsies can now be performed using minimally invasive procedures that meet these criteria. This book examines in detail vacuum-assisted minimally invasive breast biopsy systems (ATEC, EnCor, Intact, Mammotome and Vacora), stereotactic systems, MRI-guided procedures, and ductoscopy. Further chapters are devoted to the pathology of the breast tissue obtained using these procedures, their limitations, the implications of recent advances in breast imaging, and the results of cost-benefit analyses. The closing chapter provides a systematic review and meta-analysis of recent data.

Download or read book Percutaneous Breast Biopsy written by Steve H. Parker and published by Raven Press (ID). This book was released on 1993 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive treatment of large-core needle biopsy, a new technique for the early diagnosis of breast cancer. Considers the history of the technique, equipment, the principles of stereotactic mammography, and several procedures using ultrasound. The roles and perspectives of the pathologist, the nurse, and the technologist are delineated, with the emphasis on teamwork. Also evaluates fine-needle aspiration biopsy. Addressed to radiologists. Highly illustrated. Annotation copyright by Book News, Inc., Portland, OR

Download or read book Mammography and Beyond written by National Research Council and published by National Academies Press. This book was released on 2001-06-04 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt: X-ray mammography screening is the current mainstay for early breast cancer detection. It has been proven to detect breast cancer at an earlier stage and to reduce the number of women dying from the disease. However, it has a number of limitations. These current limitations in early breast cancer detection technology are driving a surge of new technological developments, from modifications of x-ray mammography such as computer programs that can indicate suspicious areas, to newer methods of detection such as magnetic resonance imaging (MRI) or biochemical tests on breast fluids. To explore the merits and drawbacks of these new breast cancer detection techniques, the Institute of Medicine of the National Academy of Sciences convened a committee of experts. During its year of operation, the committee examined the peer-reviewed literature, consulted with other experts in the field, and held two public workshops. In addition to identifying promising new technologies for early detection, the committee explored potential barriers that might prevent the development of new detection methods and their common usage. Such barriers could include lack of funding from agencies that support research and lack of investment in the commercial sector; complicated, inconsistent, or unpredictable federal regulations; inadequate insurance reimbursement; and limited access to or unacceptability of breast cancer detection technology for women and their doctors. Based on the findings of their study, the committee prepared a report entitled Mammography and Beyond: Developing Technology for Early Detection of Breast Cancer, which was published in the spring of 2001. This is a non-technical summary of that report.

Download or read book Breast Imaging written by Christoph I. Lee and published by Oxford University Press. This book was released on 2018 with total page 545 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breast Imaging presents a comprehensive review of the subject matter commonly encountered by practicing radiologists and radiology residents in training. This volume includes succinct overviews of breast cancer epidemiology, screening, staging, and treatment; overviews of all imaging modalities including mammography, tomosynthesis, ultrasound, and MRI; step-by-step approaches for image-guided breast interventions; and high-yield chapters organized by specific imaging finding seen on mammography, tomosynthesis, ultrasound, and MRI. Part of the Rotations in Radiology series, this book offers a guided approach to breast imaging interpretation and techniques, highlighting the nuances necessary to arrive at the best diagnosis and management. Each chapter contains a targeted discussion of an imaging finding which reviews the anatomy and physiology, distinguishing features, imaging techniques, differential diagnosis, clinical issues, key points, and further reading. Breast Imaging is a must-read for residents and practicing radiologists seeking a foundation for the essential knowledge base in breast imaging.

Download or read book Sentinel Lymph Node Biopsy written by Hiram S. Cody and published by CRC Press. This book was released on 2001-11-08 with total page 300 pages. Available in PDF, EPUB and Kindle. Book excerpt: An intuitive, ingenious and powerful technique, sentinel lymph node biopsy has entered clinical practice with astonishing rapidity and now represents a new standard of care for melanoma and breast cancer patients, while showing great promise for the treatment of urologic, colorectal, gynecologic, and head and neck cancers. This text, written by international experts in the technique, provides a clear and comprehensive guide, presenting a detailed overview and discussing the various mapping techniques available and how these are applied in a number of leading institutions. This essential resource for surgical onocologists, pathologists, and specialists in nuclear medicine will also provide key information for those planning to start a sentinel lymph node program.

Download or read book MRI Guided Focused Ultrasound Surgery written by Ferenc A. Jolesz and published by CRC Press. This book was released on 2007-09-26 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: MRI-Guided Focused Ultrasound Surgery will be the first publication on this new technology, and will present a variety of current and future clinical applications in tumor ablation treatment. This source helps surgeons and specialists evaluate, analyze, and utilize MRI-guided focused ultrasound surgery - bridging the gap between phase 3 clinical tr

Download or read book Contrast Enhanced Mammography written by Marc Lobbes and published by Springer. This book was released on 2019-04-29 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is a comprehensive guide to contrast-enhanced mammography (CEM), a novel advanced mammography technique using dual-energy mammography in combination with intravenous contrast administration in order to increase the diagnostic performance of digital mammography. Readers will find helpful information on the principles of CEM and indications for the technique. Detailed attention is devoted to image interpretation, with presentation of case examples and highlighting of pitfalls and artifacts. Other topics to be addressed include the establishment of a CEM program, the comparative merits of CEM and MRI, and the roles of CEM in screening populations and monitoring of response to neoadjuvant chemotherapy. CEM became commercially available in 2011 and is increasingly being used in clinical practice owing to its superiority over full-field digital mammography. This book will be an ideal source of knowledge and guidance for all who wish to start using the technique or to learn more about it.

Download or read book A Comprehensive Guide to Core Needle Biopsies of the Breast written by Sandra J. Shin and published by Springer Nature. This book was released on 2022-11-24 with total page 1025 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breast cancer remains the leading cause of cancer in women, which makes accurate diagnoses on core needle biopsy (CNB) specimens of vital importance in staging and guiding therapy decisions for patients. The first edition of this multi-authored text written by leaders in the field from major academic medical centers provided a comprehensive guide on diagnostic breast pathology in the core biopsy setting. In addition to in-depth coverage of benign and malignant entities encountered in breast core biopsies, the book provided additional resources to improve diagnostic accuracy such as pattern-based approaches to evaluation, mimickers of breast lesions arising in extra-mammary sites, and pitfalls specific to small tissue samples. In recent years, there have been several notable developments in the field of breast pathology including revisions in AJCC breast cancer staging, updated guidelines in the testing and reporting of ER, PR, and HER2, as well as implementation of immunotherapy and companion biomarker testing. In addition, several key updates were included in the most recent edition of the WHO Classification of Breast Tumours (2020). In addition to updates specific to individual breast entities, the second edition will detail updates regarding biomarker testing in the primary and metastatic setting, and incorporate newly defined entities and updated definitions of rare tumors in alignment with the WHO Classification of Breast Tumours (2020). Furthermore, this edition will address the role of CNB in companion biomarker testing for eligibility for immunotherapy in the context of advanced triple-negative breast carcinoma. Written by leaders in the field and edited by expert breast pathologists, The Second Edition of Comprehensive Guide to Core Needle Biopsies of the Breast is the definitive reference on breast core needle biopsies for practicing pathologists, pathology trainees, oncologists and clinicians of patients with breast disease.

Download or read book Fine Needle Aspiration Cytology written by Gabrijela Kocjan and published by Springer Science & Business Media. This book was released on 2006-02-23 with total page 243 pages. Available in PDF, EPUB and Kindle. Book excerpt: Histopathologists all over the world have to report cytopathology during the course of their work and it is then that they find themselves facing diagnostic dilemmas. This practical, well-illustrated book, explicitly dedicated to this readership will serve their needs and meets their requirements in daily practice.

Download or read book The Augmented Breast written by David P. Gorczyca and published by Thieme. This book was released on 1997 with total page 256 pages. Available in PDF, EPUB and Kindle. Book excerpt: Timely and comprehensive, this book clarifies what is known - and not known - about breast implants in ways that will be valuable to all clinicians. Contributions from experts in radiology, reconstructive and general surgery, pathology, immunology, and psychiatry provide important clinical insights; the final two chapters place the subject of the augmented breast in a larger social and legal context. Includes: Complete information on the use of each imaging technique in the detection of implants failure Evaluation of the advantages and disadvantages of each imaging technique Full coverage of mammography and special screening procedures for women with implants