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














  • Oncologic outcomes of self-expanding metallic stent insertion as a bridge to surgery in the management of left-sided colon cancer obstruction: comparison with nonobstructing elective surgery.

    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


    authors: Kim JS,Hur H,Min BS,Sohn SK,Cho CH,Kim NK

    更新日期:2009-06-01 00:00:00

  • Long-term result of total versus partial fundoplication after esophagomyotomy for primary esophageal motor disorders.

    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


    authors: Zhu ZJ,Chen LQ,Duranceau A

    更新日期:2008-03-01 00:00:00

  • New indication for reduction surgery in patients with advanced hepatocellular carcinoma with major vascular involvement.

    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


    authors: Gotohda N,Kinoshita T,Konishi M,Nakagohri T,Takahashi S,Furuse J,Ishii H,Yoshino M

    更新日期:2006-03-01 00:00:00

  • Role of ganglion cells in sigmoid volvulus.

    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


    authors: Furuya Y,Yasuhara H,Yanagie H,Naka S,Takenoue T,Shinkawa H,Niwa H,Kikuchi T,Nagao T

    更新日期:2005-01-01 00:00:00

  • Implementation of the World Health Organization Trauma Care Checklist Program in 11 Centers Across Multiple Economic Strata: Effect on Care Process Measures.

    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


    authors: Lashoher A,Schneider EB,Juillard C,Stevens K,Colantuoni E,Berry WR,Bloem C,Chadbunchachai W,Dharap S,Dy SM,Dziekan G,Gruen RL,Henry JA,Huwer C,Joshipura M,Kelley E,Krug E,Kumar V,Kyamanywa P,Mefire AC,Musafir M,

    更新日期:2017-04-01 00:00:00

  • The Predictors of Microscopic Vessel Invasion Differ Between Primary Hepatocellular Carcinoma and Hepatocellular Carcinoma with a Treatment History.

    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


    authors: Okamura Y,Sugiura T,Ito T,Yamamoto Y,Ashida R,Aramaki T,Uesaka K

    更新日期:2018-11-01 00:00:00

  • Comparison of mechanical bowel obstruction cases of intra-abdominal tumor and non-tumoral origin.

    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


    authors: Akcakaya A,Sahin M,Coskun A,Demiray S

    更新日期:2006-07-01 00:00:00

  • Insulin-Treated Patients with Diabetes Mellitus Undergoing Emergency Abdominal Surgery Have Worse Outcomes than Patients Treated with Oral Agents.

    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


    authors: Haltmeier T,Benjamin E,Beale E,Inaba K,Demetriades D

    更新日期:2016-07-01 00:00:00

  • Aesthetic surgery for benign disorders of the breast.

    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


    authors: Carlson G,Bostwick J 3rd

    更新日期:1989-11-01 00:00:00

  • Single-Site Robotic Cholecystectomy: The Timeline of Progress.

    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


    authors: Bibi S,Rahnemai-Azar AA,Coralic J,Bayoumi M,Khorsand J,Farkas DT,Prasad LM

    更新日期:2015-10-01 00:00:00

  • Sternocleidomastoid muscle myocutaneous flap for corrosive pharyngoesophageal strictures.

    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


    authors: Ananthakrishnan N,Parthasarathy G,Maroju NK,Kate V

    更新日期:2007-08-01 00:00:00

  • Muscle Steatosis is an Independent Predictor of Postoperative Complications in Patients with Hepatocellular Carcinoma.

    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


    authors: Hamaguchi Y,Kaido T,Okumura S,Kobayashi A,Fujimoto Y,Ogawa K,Mori A,Hammad A,Hatano E,Uemoto S

    更新日期:2016-08-01 00:00:00

  • Pathogenesis of pain in chronic pancreatitis: ongoing enigma.

    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


    authors: Bornman PC,Marks IN,Girdwood AW,Berberat PO,Gulbinas A,Büchler MW

    更新日期:2003-11-01 00:00:00

  • Increased serum interleukin-8: correlation with poor prognosis in patients with postoperative multiple organ failure.

    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


    authors: Hamano K,Gohra H,Noda H,Katoh T,Fujimura Y,Zempo N,Esato K

    更新日期:1998-10-01 00:00:00

  • Radiological evaluation of benign breast disorders.

    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


    authors: Gravelle IH,Lyons K

    更新日期:1989-11-01 00:00:00

  • Cardiovascular and Cerebrovascular Events After Parathyroidectomy in Patients on Renal Replacement Therapy.

    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

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    authors: Ivarsson KM,Akaberi S,Isaksson E,Reihnér E,Czuba T,Prütz KG,Clyne N,Almquist M

    更新日期:2019-08-01 00:00:00

  • Stage III thick (>4.0 mm) lower extremity melanoma: is timing of lymph node involvement a prognostic factor?

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    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Herman K,Wysocki WM,Skotnicki P,Tabor J,Luczyńska E,Komorowski AL

    更新日期:2009-03-01 00:00:00

  • Wound healing after open appendectomies in adult patients: a prospective, randomised trial comparing two methods of wound closure.

    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


    authors: Kotaluoto S,Pauniaho SL,Helminen M,Kuokkanen H,Rantanen T

    更新日期:2012-10-01 00:00:00

  • Effect of sirolimus in the prevention of adhesions around intraabdominal prosthetic graft.

    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


    authors: Kanko M,Ozbudak E,Ozerdem A,Aksoy A,Kilic M,Berki KT

    更新日期:2006-09-01 00:00:00

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    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


    authors: Turkcapar A,Kepenekci I,Mahmoud H,Tuzuner A

    更新日期:2007-11-01 00:00:00

  • Options and strategies for the management of choledocholithiasis.

    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


    authors: Rosenthal RJ,Rossi RL,Martin RF

    更新日期:1998-11-01 00:00:00

  • Intrapulmonary expression of scavenger receptor and CD14 and their relation to local inflammatory responses to endotoxemia in mice.

    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


    authors: Jiang JX,Chen YH,Xie GQ,Ji SH,Liu DW,Qiu J,Zhu PF,Wang ZG

    更新日期:2003-01-01 00:00:00

  • The Predictive Value of Indocyanine Green Clearance in Future Liver Remnant for Posthepatectomy Liver Failure Following Hepatectomy with Extrahepatic Bile Duct Resection.

    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


    authors: Yokoyama Y,Ebata T,Igami T,Sugawara G,Mizuno T,Yamaguchi J,Nagino M

    更新日期:2016-06-01 00:00:00

  • Risk factors for infection after 46,113 intramedullary nail operations in low- and middle-income countries.

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    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Young S,Lie SA,Hallan G,Zirkle LG,Engesæter LB,Havelin LI

    更新日期:2013-02-01 00:00:00

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    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


    authors: Hirsch EF,Bowers GJ

    更新日期:1992-09-01 00:00:00

  • Systematic review and meta-analysis of enhanced recovery after pancreatic surgery with particular emphasis on pancreaticoduodenectomies.

    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


    authors: Coolsen MM,van Dam RM,van der Wilt AA,Slim K,Lassen K,Dejong CH

    更新日期:2013-08-01 00:00:00

  • Retrospective Analyses of Esophageal Bypass Surgery for Patients with Esophagorespiratory Fistulas Caused by Esophageal Carcinomas.

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    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Nakajima Y,Kawada K,Tokairin Y,Miyawaki Y,Okada T,Miyake S,Kawano T

    更新日期:2016-05-01 00:00:00

  • Use of Liver Function Tests as First-line Diagnostic Tools for Predicting Common Bile Duct Stones in Acute Cholecystitis Patients.

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    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Ahn KS,Yoon YS,Han HS,Cho JY

    更新日期:2016-08-01 00:00:00

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    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Nam IC,Bae JS,Chae BJ,Shim MR,Hwang YS,Sun DI

    更新日期:2013-08-01 00:00:00

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    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


    authors: Sugarbaker PH

    更新日期:1991-09-01 00:00:00