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:BACKGROUND:Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobs...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0007-5
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:The selection of the type of fundoplication or the necessity for an added fundoplication after esophagomyotomy (Heller's operation) for the treatment of achalasia remains controversial. The present retrospective study was designed to compare the long-term results of total and partial fundoplication on the my...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9385-8
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The prognosis of advanced hepatocellular carcinoma (HCC) remains poor, particularly in patients with tumor thrombi (TT) in the major vessels. PATIENTS AND METHODS:From July 1992 to October 2004, 161 patients diagnosed as having advanced HCC with major vascular involvement were seen consecutively at our hosp...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0250-3
更新日期:2006-03-01 00:00:00
abstract::The aim of this study was to clarify the role of ganglion cells in the development and recurrence of sigmoid volvulus. We analyzed 9 samples obtained from 9 patients who had undergone sigmoidectomy for sigmoid volvulus, and, for comparison, 18 samples from 18 patients who had undergone sigmoidectomy or low anterior re...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7462-9
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Trauma contributes more than ten percent of the global burden of disease. Initial assessment and resuscitation of trauma patients often requires rapid diagnosis and management of multiple concurrent complex conditions, and errors are common. We investigated whether implementing a trauma care checklist would ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3759-8
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND AND AIM:Previous studies have shown that microscopic vessel invasion (MVI) occurs in hepatocellular carcinoma (HCC) with a treatment history due to its poorer malignant behavior in comparison with primary HCC. The aim of the present study was to determine the predictors of MVI and overall survival in HCC pat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4658-y
更新日期:2018-11-01 00:00:00
abstract:INTRODUCTION:Mechanical bowel obstruction cases constitute an important place in emergency health care services. In this study, bowel obstructions caused by intra-abdominal tumors were compared with those without tumoral causes. PATIENTS AND METHODS:A total of 155 cases of mechanical bowel obstruction diagnosed were r...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0440-z
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus (DM) is a known risk factor for worse outcomes after emergency abdominal surgery (EAS). However, it is unclear if the type of diabetes treatment (insulin or oral agents) has any effect on outcomes after EAS. METHODS:Matched cohort study utilizing the ACS NSQIP database. Patients with DM un...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3469-2
更新日期:2016-07-01 00:00:00
abstract::Those benign breast disorders that are amenable to improvement by aesthetic surgery are discussed from the points of view of indications, techniques, and results. ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658430
更新日期:1989-11-01 00:00:00
abstract:AIM:To investigate the learning curve and perioperative outcomes of single-site robotic cholecystectomy during the first 102 cases by a single surgeon. MATERIALS AND METHODS:A retrospective review of a prospectively maintained database was performed on the first 102 cases of single-site robotic cholecystectomy. Patien...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3135-0
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Strictures at the pharyngoesophageal junction represent a subgroup of corrosive esophageal strictures requiring a specialized management approach. Non-dilatable cricopharyngeal strictures need surgical intervention. We report the use of the sternocleidomastoid muscle myocutaneous inlay flap (SCMMIF) for reco...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9120-5
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Skeletal muscle depletion, referred to as sarcopenia, has been shown to be an independent predictor of lower disease-free and overall survivals in various kinds of diseases. The quality of skeletal muscle has recently attracted much attention as a new parameter of sarcopenia, but its impact on surgical compl...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3504-3
更新日期:2016-08-01 00:00:00
abstract::The pathogenesis of pain in chronic pancreatitis remains an enigma. The cause of pain is almost certainly multifactorial and may vary at different stages of the disease process. These factors may include the release of excessive oxygen-derived free radicals, tissue hypoxia and acidosis, inflammatory infiltration with ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-003-7235-x
更新日期:2003-11-01 00:00:00
abstract::This study investigated whether cytokines and colony-stimulating factors can predict prognosis in patients with postoperative multiple organ failure (MOF). We evaluated 14 patients with postoperative MOF who underwent operation for cardiovascular disease. Seven patients recovered from MOF (survivors) and seven did not...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900520
更新日期:1998-10-01 00:00:00
abstract::The radiological features of common benign conditions of the breast and the radiological procedures used in the investigation of benign breast disorders are presented. ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658415
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:A majority of patients with end-stage renal disease suffer from secondary hyperparathyroidism, which is associated with osteoporosis and cardiovascular disease. Parathyroidectomy (PTX) is often necessary despite medical treatment. However, the effect of PTX on cardio- and cerebrovascular events (CVE) remains...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05020-z
更新日期:2019-08-01 00:00:00
abstract:PURPOSE:The prognosis for stage III melanoma patients is mixed, and there is need for new prognostic factors to be incorporated into a revision of melanoma TNM staging. We analyzed the possible role of the timing of lymph node involvement as an important prognostic factor. METHODS:Among 249 melanoma patients who under...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9895-z
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:The skin is closed in open appendectomy traditionally with few interrupted nonabsorbable sutures. The use of this old method is based on a suggestion that this technique decreases wound infections. In pediatric surgery, skin closure with running intradermal absorbable sutures has been found to be as safe as ...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1664-3
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Adhesions due to the reactions caused by the grafts used in primary vascular operations can lead to various problems when a secondary operation is necessary. These problems include bleeding, injuries to neighboring organs, and complications occurring due to a prolonged operation. We investigated the effects ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0750-1
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Despite the good results reported after laparoscopic fundoplication, failure is still a major problem. Hiatal disruption is one of the common patterns of anatomical failure. The aim of this study was to compare the results of suture repair of diaphragmatic crura with routine polypropylene mesh reinforcement ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9066-7
更新日期:2007-11-01 00:00:00
abstract::The introduction of laparoscopic techniques for the management of biliary stone disease has expanded the therapeutic choices for surgeons confronted with choledocholithiasis. As new strategies emerge, the treatment of cholelithiasis and choledocholithiasis remains controversial. This paper discusses the options availa...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900531
更新日期:1998-11-01 00:00:00
abstract::This study was first designed to investigate systematically the kinetics of surface expression of scavenger receptors (SRs) and CD14 on alveolar macrophages in vivo and in vitro and their relation with local pro- and antiinflammatory responses in endotoxemia. The expression of SR and CD14 in lungs was down- and up-reg...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6548-5
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Postoperative liver failure (PHLF) is one of the most common complications following major hepatectomy. The preoperative assessment of future liver remnant (FLR) function is critical to predict the incidence of PHLF. OBJECTIVE:To determine the efficacy of the plasma clearance rate of indocyanine green clear...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3441-1
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:The fields of surgery and trauma care have largely been neglected in the global health discussion. As a result the idea that surgery is not safe or cost effective in resource-limited settings has gone unchallenged. The SIGN Online Surgical Database (SOSD) is now one of the largest databases on trauma surgery...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1817-4
更新日期:2013-02-01 00:00:00
abstract::The combination of conventional traumatic injuries and radiation exposure has synergistic consequences, the full extent of which may take days to weeks to become apparent. Our understanding of such is derived from a variety of laboratory and clinical scenarios involving both therapeutic and accidental exposures. When ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02066992
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:In the past decade, Enhanced Recovery after Surgery (ERAS) protocols have been implemented in several fields of surgery. With these protocols, a faster recovery and shorter hospital stay can be accomplished without an increase in morbidity or mortality. The purpose of this study was to review systematically ...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-013-2044-3
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Esophagorespiratory fistula (ERF) caused by esophageal carcinoma is a fatal complication. In our institution, esophageal bypass surgery has been indicated when possible. We herein retrospectively describe the clinical results of esophageal bypass surgery for ERF. PATIENTS AND METHODS:Between April 2001 and ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3391-z
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Prior studies have examined the use of liver function tests (LFT) for predicting the presence of common bile duct (CBD) stones in chronic cholecystitis (CC) patients. It is currently unclear whether LFT are also useful for predicting CBD stones in patients with acute cholecystitis (AC). METHODS:Of 1059 pati...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3517-y
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:A lower-pitched voice is one of the most common voice alterations after thyroidectomy without laryngeal nerve injury. The aim of this study was to evaluate the acoustic and stroboscopic changes and the treatment outcomes in patients with a lower-pitched voice with the goal of eventually establishing a therap...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2062-1
更新日期:2013-08-01 00:00:00
abstract::Experience with screening for colorectal cancer has been disappointing. Prevention of this disease seems to be a more beneficial research direction. Although radical surgery presents the best treatment option, it is nonetheless an inadequate strategy by itself. A new dose intensive approach would temporally combine su...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01789207
更新日期:1991-09-01 00:00:00