Abstract:
INTRODUCTION:Percutaneous needle biopsy (PNB) is the standard of care for diagnosis of breast lesions. Rates of excisional biopsy for breast diagnosis in North America have been reported at approximately 35 %, although significant regional variation exists. A target rate of PNB for diagnosis of breast abnormalities is needed to facilitate quality improvement. We sought to describe the use of PNB in a referral practice, the clinical scenarios prompting PNB or surgical biopsy (SB), and the accuracy and rate of PNB to inform the ultimate development of a benchmark rate of PNB in breast diagnosis. MATERIALS AND METHODS:Female patients age 18-90 years, referred to Sunnybrook Health Sciences Centre, a large teaching hospital affiliated with the University of Toronto, with a breast lesion prompting tissue diagnosis with SB and/or PNB between 2002 and 2009 were studied. Each biopsied lesion was characterized by method of biopsy: PNB, SB, or PNB followed by SB. For each lesion, we collected data on patient demographics and breast cancer risk, reason for referral, imaging characteristics (breast imaging-reporting and data system classification, full description, final impression before biopsy), and pathology from each biopsy method. We report concordance between the final impression pre-biopsy and the PNB diagnosis with final surgical diagnosis where applicable. RESULTS:One thousand and twenty-six lesions were biopsied, 987 (96 %) with PNB. The benign:malignant ratio for the entire cohort was 1.2:1. Final impression was concordant with final pathology in 674/862 (78 %) and PNB diagnosis was concordant with SB pathology in 487/556 (88 %). The reasons for SB without PNB were required pathologic evaluation of the entire lesion (n = 19), patient choice (n = 5), other biopsy technique used (n = 6), technical (n = 4), planned mastectomy (n = 3), and enlarging mass (n = 2). 155/559 (28 %) of lesions without evidence of malignancy on PNB ultimately underwent SB. Papillary lesions and radial scars were more likely to undergo SB with or without prior PNB. Lesions deemed to be suspicious or malignant on final impression were more likely to be excised after a benign diagnosis at PNB. CONCLUSION:The vast majority of lesions requiring tissue diagnosis can be accurately diagnosed with PNB. Benchmarks for rates of PNB of 90 % or greater may be considered for performance measurement in appropriate populations.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Holloway CM,Al-Riyees L,Saskin Rdoi
10.1007/s00268-015-3293-0subject
Has Abstractpub_date
2016-07-01 00:00:00pages
1590-9issue
7eissn
0364-2313issn
1432-2323pii
10.1007/s00268-015-3293-0journal_volume
40pub_type
杂志文章abstract::The primal need for nutrients is satisfied by mechanisms for sensing internal stores and detecting food; ATP is the most primitive signal. With increasing density of sensory neurons and glia (the primordial brain) and the emergence of autonomic neural activity throughout the endoderm, transmitters and other signaling ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0138-8
更新日期:2009-10-01 00:00:00
abstract::From January, 1972 to June, 1989, 51 patients with liver hemangiomas (32 females and 19 males, mean age 35 years) were evaluated for surgical treatment. Diameters of the masses were 5 cm to 20 cm (median 8.5 cm). Nine of the patients had already been treated for cancer. Twenty-two (43.1%) of the 51 patients were sympt...
journal_title:World journal of surgery
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doi:10.1007/BF02104457
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abstract:BACKGROUND:This study evaluated the impact of tumor regression grading (TRG) and other pathologic variates in a cohort of rectal carcinoma patients treated with neoadjuvant chemoradiotherapy (CRT). The value of a grading less than pCR for predicting survival is unknown. Tumor budding has not been systematically studied...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1409-8
更新日期:2012-03-01 00:00:00
abstract::Precise localization of cervical node metastasis of papillary thyroid carcinoma is rarely described. The aim of this retrospective study was to map their cervical involvement. Between 1974 and 1996 a series of 119 patients had total thyroidectomy with bilateral cervical lymph node dissection. Patients who had secondar...
journal_title:World journal of surgery
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abstract:BACKGROUND:The purpose of the present study was to analyze the risk multi-factors of postoperative cardiac arrhythmia for elderly patients with esophageal or cardiac carcinoma. METHODS:A total of 756 operations for elderly patients (>65 years of age) with esophageal or cardiac carcinoma were performed in our departmen...
journal_title:World journal of surgery
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doi:10.1007/s00268-009-0222-0
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abstract:BACKGROUND:Surgeon performed ultrasound (US) is being increasingly embraced by breast surgeons worldwide as an integral part of patient assessment. The extent of its application within Australia and New Zealand is not well documented. The present study aimed to evaluate its current usage patterns and to determine suita...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2076-8
更新日期:2013-09-01 00:00:00
abstract::Malignant melanoma is notoriously resistant to chemotherapy. Standard single agents include dacarbazine and the nitrosoureas, but most series treating patients with metastatic melanoma report response rates of about 20%. Occasional patients, however, achieve long term remission, amounting to cure, after such treatment...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02071532
更新日期:1992-03-01 00:00:00
abstract:INTRODUCTION:The coexistence of an enterocutaneous fistula (ECF) with large abdominal wall defects represent one of the most demanding situations seen by a surgeon. Simultaneous treatment of ECF closure with abdominal wall defect closure has been widely debated. Our objective was to determine if the type of abdominal w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05635-7
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abstract::Because of the rarity of adrenocortical carcinoma, survival rates and the prognosis for patients who have undergone operation are not well known. The purpose of the French Association of Endocrine Surgery was to evaluate these factors over an 18-year period. A trend study was associated to assess changes in the clinic...
journal_title:World journal of surgery
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journal_title:World journal of surgery
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更新日期:2008-06-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00013182
更新日期:1999-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9008-4
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Although the low central venous pressure (LCVP) technique is used to decrease blood loss during liver resection, its efficacy and safety during transplant procedures are still debatable. Our study aimed to assess the effects of this technique and its clinical safety for recipients undergoing liver transplant...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-010-0544-y
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:We investigated the implications of HER2 amplification in Asian women with small, node-negative breast cancer in low- and middle-income countries (LMCs). METHODS:We reviewed the charts patients treated between 1989 and 2009 with breast conservation therapy for node-negative breast cancers measuring ≤ 2 cm. ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1353-7
更新日期:2012-02-01 00:00:00
abstract::Hepatoblastoma is a rare pediatric malignancy that frequently appears in an advanced unresectable stage. Improved resectability and survival rate have been reported with the help of neoadjuvant chemotherapy. Between January 1987 and June 1995 a series of 20 patients were managed with a diagnosis of hepatoblastoma. The...
journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2001-02-01 00:00:00
abstract::Noninvasive diagnosis of cavernous hemangioma of the liver is an important step in the investigation of patients with focal hepatic lesions since biopsy may result in life-threatening hemorrhage. To determine the diagnostic accuracy of 99m-technetium red blood cell (99mTc-RBC) imaging with tomography, 50 patients with...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658668
更新日期:1990-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s00268-004-2073-z
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Routine preoperative staging in pancreas cancer is controversial. We sought to evaluate the rates of diagnostic laparoscopy (DLAP) for pancreatic cancer. METHODS:We queried the National Surgical Quality Improvement Program for patients with pancreas cancer (2005-2013) and compared groups who underwent DLAP,...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4855-8
更新日期:2019-03-01 00:00:00
abstract::This study aimed to investigate the effects and timing of local anesthesia during laparoscopic surgery in terms of postoperative pain, nausea, and the need for opioids and antiemetics. This prospective study was carried out on 142 patients who underwent laparoscopic cholecystectomy. Peroperative local anesthesia was n...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7350-3
更新日期:2004-08-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2078-6
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2866-7
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00308633
更新日期:1995-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-018-4731-6
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The aim of this work was to study the impact of anemia on surgical outcomes and the impact of instituting appropriate workup and treatment of anemia on surgical outcomes. METHODS:We conducted a case-control retrospective chart review of all hernia repair, hydrocele repair, and hysterectomy cases at the SEAR...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1615-z
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The psychiatric population has been reported to be accompanied with a higher morbidity and mortality in several situations. However, little is known about the effect of co-morbid psychiatric disorders on surgical risk during major digestive surgery for malignancies. Our purpose in the present study, therefor...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9267-0
更新日期:2007-12-01 00:00:00
abstract::This article presents an analysis of acute gastroduodenal mucosal lesions (AGML) based on a review of current literature and the personal experience of the authors. The pathology of AGML involes two distinct types of lesions, namely, superficial erosions confined to the acid-secreting gastric mucosa and presenting as ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01654729
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Many patients who undergo emergency laparotomy are working, which is a key determinant for an individual's socio-economic status and financial security. The objectives of this study were to compare labour market participation and sick leave in a nationwide patient population undergoing non-malignant emergenc...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4830-4
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:The present study was designed to evaluate the impact of the tyrosine kinase ligands VEGF-A/C/D, PDGF-A/B on tumor dissemination and survival in gastric cancer. This is the first study analyzing all these parameters in a homogeneous patient population undergoing surgery. METHODS:The expression pattern of VE...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1041-7
更新日期:2011-05-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:1992-01-01 00:00:00