Utilization of Percutaneous Needle Biopsy for Breast Diagnosis in a Comprehensive Breast Center: Implications for Development of Quality Indicators.


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.


World J Surg


World journal of surgery


Holloway CM,Al-Riyees L,Saskin R




Has Abstract


2016-07-01 00:00:00














  • The influence of surgery on endocrine ophthalmopathy.

    abstract::Since the pathogenesis of endocrine ophthalmopathy is unclear, there has been little agreement on the treatment of the disease. The influence of thyroid surgery on endocrine ophthalmopathy is controversial. To evaluate the effect of thyroid surgery on the course of the disease, we developed a special ophthalmopathy in...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Frilling A,Goretzki PE,Grussendorf M,Erbslöh M,Röher HD

    更新日期:1990-05-01 00:00:00

  • Impact of gender and age on the long-term outcome of laparoscopic fundoplication.

    abstract:BACKGROUND:It has been suggested that gender and age could be factors that influence the likelihood of success following antireflux surgery, and our anecdotal impression has been that the outcome following Nissen fundoplication in older women is often disappointing. If correct, characterization of the extent of any dif...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Beck PE,Watson DI,Devitt PG,Game PA,Jamieson GG

    更新日期:2009-12-01 00:00:00

  • Pattern of organ failure following severe trauma.

    abstract::Multiple organ failure (MOF) is considered to be the leading cause of death after severe trauma. Although there is extensive literature on MOF, little is known about the pattern, sequence, and onset of this clinical syndrome. The first goal of this clinical study was to define MOF; the second was to assess the typical...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Regel G,Grotz M,Weltner T,Sturm JA,Tscherne H

    更新日期:1996-05-01 00:00:00

  • Cardiopulmonary assessment: is improvement needed?

    abstract::Clinical parameters alone have repeatedly been proven unreliable in assessing cardiopulmonary status, especially in hemodynamically unstable patients. To learn if we had a diagnostic problem in our hospital, we compared physician assessment of cardiac index (CI) and thoracic fluid content (TFC) to values obtained usin...

    journal_title:World journal of surgery

    pub_type: 临床试验,杂志文章


    authors: Van De Water JM,Dalton ML,Parish DC,Vogel RL,Beatty JC,Adeniyi SO

    更新日期:2005-01-01 00:00:00

  • Management of biofilm infections in the urinary tract.

    abstract::Bacterial biofilms develop on a number of living and inert surfaces within the urinary tract, producing chronic intractable infections. The role of exopolysaccharides in producing a variety of extracellular polymeric substances according to the infection site and bacterial species and the clinical features of the resu...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Kumon H

    更新日期:2000-10-01 00:00:00

  • Overview of randomized clinical trials of total parenteral nutrition for malnourished surgical patients.

    abstract::The past decade has seen a maturation of the art and science of perioperative nutritional support. We now have sufficient data to make informed and reasonable judgments regarding when we should and should not provide perioperative TPN. These judgments can be considered medically sound and fiscally responsible. The fol...

    journal_title:World journal of surgery

    pub_type: 临床试验,杂志文章,随机对照试验,评审


    authors: Buzby GP

    更新日期:1993-03-01 00:00:00

  • A Distance Blended Learning Program to Upgrade the Clinical Competence of District Non-doctor Anesthesia Providers in Nepal.

    abstract:BACKGROUND:Across Nepal, anesthesia at a district level is provided mostly by non-doctor anesthesia providers (anesthesia assistants-AAs). Nepal's Government recognized the need to sustain competence with continuous professional development and to upgrade 6-month trained working AAs to professional equivalence with the...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Shah S,Knoble S,Ross O,Pickering S

    更新日期:2017-12-01 00:00:00

  • Impact of Biliary Drainage on Multidetector-Row Computed Tomography on R0 Resection of Perihilar Cholangiocarcinoma.

    abstract:BACKGROUND:Although multidetector-row computed tomography (MDCT) before biliary drainage is useful for the assessment of the resectability of perihilar cholangiocarcinoma (PHC), the impact of biliary drainage on MDCT images before surgical resection for PHC has been poorly studied, and its possible consequences for R0 ...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Hosokawa I,Shimizu H,Yoshitomi H,Furukawa K,Takayashiki T,Miyazaki M,Ohtsuka M

    更新日期:2018-11-01 00:00:00

  • Hepatic surgery and hepatic surgical anatomy: historical partners in progress.

    abstract::Whether for hepatic trauma or transplantation, a surgeon's knowledge of hepatic anatomy commonly determines a patient's outcome. The first medically relevant anatomic studies of the liver emerged with the endeavors of Herophilus and Erasistratus between 310 and 280 bc. Yet it was not until after the development of ane...

    journal_title:World journal of surgery

    pub_type: 传,历史文章,杂志文章


    authors: McClusky DA 3rd,Skandalakis LJ,Colborn GL,Skandalakis JE

    更新日期:1997-03-01 00:00:00

  • Predictors of mortality in skin and soft-tissue infections caused by Vibrio vulnificus.

    abstract:BACKGROUND:Vibrio vulnificus infection can progress rapidly in skin or soft tissue, and it is potentially life-threatening. The purpose of the present study was to explore the predictors of mortality in patients with V. vulnificus infections of skin or soft tissue. METHODS:The medical records of 119 consecutive patien...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Kuo Chou TN,Chao WN,Yang C,Wong RH,Ueng KC,Chen SC

    更新日期:2010-07-01 00:00:00

  • Robot-assisted pediatric surgery: how far can we go?

    abstract:BACKGROUND:The purpose of this study was to assess the safety and feasibility of performing robot-assisted pediatric surgery using the da Vinci Surgical System in a variety of surgical procedures. METHODS:A retrospective review of 144 robot-assisted pediatric surgical procedures performed in our institution between Ju...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Alqahtani A,Albassam A,Zamakhshary M,Shoukri M,Altokhais T,Aljazairi A,Alzahim A,Mallik M,Alshehri A

    更新日期:2010-05-01 00:00:00

  • Stent-graft treatment for isolated infrarenal aortic dissecting aneurysms.

    abstract:OBJECTIVES:We report three cases of isolated infrarenal aortic dissecting aneurysms managed with stent-graft. MATERIALS AND METHODS:Three patients, two men and one woman, with a mean age at diagnosis of 69 years were identified. In all cases, chest CT-A did not reveal evidence of thoracic aortic dissection. The mean m...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Caronno R,Piffaretti G,Tozzi M,Lomazzi C,Rivolta N,Laganà D,Carrafiello G,Cuffari S,Castelli P

    更新日期:2006-07-01 00:00:00

  • Long-term quality of life after hepatic resection: health is not simply the absence of disease.

    abstract:BACKGROUND:Due to advances in operative methods and perioperative care, mortality and morbidity following major hepatic resection have decreased substantially, making long-term quality of life (QoL) an increasingly prominent issue. We evaluated whether postoperative diagnosis was associated with long-term QoL and healt...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Banz VM,Inderbitzin D,Fankhauser R,Studer P,Candinas D

    更新日期:2009-07-01 00:00:00

  • Adjuvant therapy for patients with colorectal cancer.

    abstract::There are now excellent data that patients with stage III colon cancer or stage II and III rectal cancer live longer if they receive, respectively, systemic or regional and systemic therapy after surgery. In addition, disease-free survival, particularly freedom from the symptoms of regional recurrence, in the high ris...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Steele G Jr

    更新日期:1995-03-01 00:00:00

  • Overview of the development of personalized genomic medicine and surgery.

    abstract::Personalized genomic medicine and surgery (PGMS) represents a new approach to health care that customizes patients' medical treatment according to their own genetic information. This new approach is the result of increased knowledge of the human genome and ways this information can be applied by physicians in the medi...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Brunicardi FC,Gibbs RA,Wheeler DA,Nemunaitis J,Fisher W,Goss J,Chen C

    更新日期:2011-08-01 00:00:00

  • Investigation of the lymphatic stream of the stomach in gastric cancer with solitary lymph node metastasis.

    abstract:BACKGROUND:Understanding the lymphatic drainage route in gastric cancer is crucial for complete lymph node retrieval from sites susceptible to metastasis. However, the lymphatic stream of the stomach is complex and remains incompletely characterized. METHODS:Patients with small (<4 cm) serosa-negative gastric cancer w...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Tokunaga M,Ohyama S,Hiki N,Fukunaga T,Yamada K,Sano T,Yamaguchi T

    更新日期:2009-06-01 00:00:00

  • Identification of risk factors for perioperative mortality in acute mesenteric ischemia.

    abstract:INTRODUCTION:Acute intestinal ischemia is in most cases a lethal condition with a low survival rate. Risk factors of perioperative mortality are poorly defined. The aim of this study was to define risk factors that predict an adverse outcome of acute mesenteric ischemia (AMI). METHODS:A total of 132 consecutive patien...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Acosta-Merida MA,Marchena-Gomez J,Hemmersbach-Miller M,Roque-Castellano C,Hernandez-Romero JM

    更新日期:2006-08-01 00:00:00

  • Critical Care Management of Peritonitis in a Low-Resource Setting.

    abstract:BACKGROUND:Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS:Data were collected at a...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Rickard J,Ngarambe C,Ndayizeye L,Smart B,Riviello R,Majyambere JP

    更新日期:2018-10-01 00:00:00

  • Concomitant analysis of the epidermal growth factor receptor family in esophageal cancer: overexpression of epidermal growth factor receptor mRNA but not of c-erbB-2 and c-erbB-3.

    abstract::The epidermal growth factor receptor family consists of four closely related transmembrane receptors: epidermal growth factor receptor (EGF-R), c-erbB-2, c-erbB-3, and c-erbB-4. Overexpression of each receptor may lead to cell transformation and contributes to tumor progression in various malignancies. Although these ...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Friess H,Fukuda A,Tang WH,Eichenberger A,Furlan N,Zimmermann A,Korc M,Büchler MW

    更新日期:1999-10-01 00:00:00

  • Comparison of Surgical Outcomes Between Robotic and Laparoscopic Distal Gastrectomy for cT1 Gastric Cancer.

    abstract:BACKGROUND:Increasing numbers of patients are treated by robotic distal gastrectomy (RDG); however, it remains unclear whether RDG is clinically comparable with conventional laparoscopic distal gastrectomy (LDG). This study aimed to clarify the feasibility of RDG from safety aspects. METHODS:The study included 109 cT1...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Hikage M,Tokunaga M,Makuuchi R,Irino T,Tanizawa Y,Bando E,Kawamura T,Terashima M

    更新日期:2018-06-01 00:00:00

  • Topical Steroids Are Effective in the Treatment of Idiopathic Granulomatous Mastitis.

    abstract:BACKGROUND:Idiopathic granulomatous mastitis (IGM) is a rare, benign, and chronic disease of the breast. Despite the various treatment approaches described for this disease, a gold standard treatment modality has not yet been defined. In this study, the effect of topical steroids was reviewed and assessed in patients w...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Altintoprak F,Kivilcim T,Yalkin O,Uzunoglu Y,Kahyaoglu Z,Dilek ON

    更新日期:2015-11-01 00:00:00

  • Management of hyperthyroidism due to Graves' and nodular diseases.

    abstract::Endocrine surgeons have had an important role in the management of hyperthyroidism due to either Graves' disease or toxic nodule(s). Since alternative treatments such as antithyroid drugs or radioiodine are also available, the decision-making for management should be based on clear assessment of advantages and limitat...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Okamoto T,Iihara M,Obara T

    更新日期:2000-08-01 00:00:00

  • Efficacy of 10% sucralfate ointment in the reduction of acute postoperative pain after open hemorrhoidectomy: a prospective, double-blind, randomized, placebo-controlled trial.

    abstract:BACKGROUND:The aim of the present study was to evaluate the efficacy of 10 % sucralfate ointment in the reduction of acute postoperative pain after open hemorrhoidectomy. METHODS:A total of 48 patients (24 men and 24 women) between 20 and 70 years of age who underwent open hemorrhoidectomy were included in this prospe...

    journal_title:World journal of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Ala S,Saeedi M,Eshghi F,Rafati M,Hejazi V,Hadianamrei R

    更新日期:2013-01-01 00:00:00

  • Clinicoanatomical study on the infraportal bile ducts of segment 3.

    abstract::In some patients, bile ducts of segments 2 and 3 (B2 and B3) run caudally to the umbilical portion of the left portal vein (UP)--an infraportal course. We aimed to evaluate the frequency and clinical implications of this variation. Between January 1992 and October 2000, 108 patients underwent resection for hilar chola...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Ozden I,Kamiya J,Nagino M,Uesaka K,Sano T,Nimura Y

    更新日期:2002-12-01 00:00:00

  • Twenty years of laparoscopic fundoplication for GERD.

    abstract::The first laparoscopic Nissen fundoplication was performed 20 years ago. Surgical management of gastroesophageal reflux disease (GERD) should be offered only to appropriately studied and selected patients, with the ultimate aim of improving the well-being of the individual, the "quality of life." The choice of fundopl...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Dallemagne B,Perretta S

    更新日期:2011-07-01 00:00:00

  • A randomized controlled trial comparing post-operative pain in single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy.

    abstract:INTRODUCTION:An increasing body of evidence is being published about single-incision laparoscopic cholecystectomy (SILC), but there are no well-powered trials with an adequate evaluation of post-operative pain. This randomized trial compares SILC against four-port laparoscopic cholecystectomy (LC) with post-operative p...

    journal_title:World journal of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Chang SK,Wang YL,Shen L,Iyer SG,Madhavan K

    更新日期:2015-04-01 00:00:00

  • Trauma Patients with an Open Abdomen Following Damage Control Laparotomy can be Extubated Prior to Abdominal Closure.

    abstract:BACKGROUND:The open abdomen (OA) is commonly utilized as a technique during damage control laparotomy (DCL). We propose that a selected group of these OA patients can be extubated prior to abdominal closure to decrease ventilator days and risk of pneumonia. METHODS:A retrospective chart review was performed at a Level...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Sujka JA,Safcsak K,Cheatham ML,Ibrahim JA

    更新日期:2018-10-01 00:00:00

  • Surgical Consideration Based on Lymph Nodes Spread Patterns in Patients with Peripheral Right Middle Non-small Cell Lung Cancer 3 cm or Less.

    abstract:BACKGROUND:The optimal extent of lung resection and lymph nodes dissection for peripheral early-stage right middle non-small cell lung cancer (NSCLC) still remains controversial. In this study, we analyzed the patterns of lymph nodes metastasis (LNM) of patients with peripheral right middle NSCLC ≤ 3 cm, aiming to prov...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Wang R,Deng HY,Zhou J,Jiang R,Zhou Q

    更新日期:2020-10-01 00:00:00

  • Surgical site infection following surgery for inflammatory bowel disease in patients with clean-contaminated wounds.

    abstract:BACKGROUND:It is generally believed that the accompanying conditions in patients with inflammatory bowel disease (IBD) are associated with a high incidence of surgical site infection (SSI), and sometimes these patients are classified as compromised hosts without definitive clinical evidence. The aim of this study was t...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Uchino M,Ikeuchi H,Tsuchida T,Nakajima K,Tomita N,Takesue Y

    更新日期:2009-05-01 00:00:00

  • Clinical Trials of Active Surveillance of Papillary Microcarcinoma of the Thyroid.

    abstract:BACKGROUND:The incidence of thyroid cancer is increasing globally. This is mainly due to the increase in the detection of small papillary carcinomas, including papillary microcarcinomas (PMC) 1 cm or smaller. It was suggested recently that PMCs are overdiagnosed and overtreated. METHODS:In 1993, the author proposed a ...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Miyauchi A

    更新日期:2016-03-01 00:00:00