A Comparison of the Prognostic Effects of Fine Needle Aspiration and Core Needle Biopsy in Patients with Breast Cancer: A Nationwide Multicenter Prospective Registry
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Definitions
2.3. Statistical Analysis
2.4. Subgroup Analysis
3. Results
3.1. Time Trends in Breast Biopsy Practice
3.2. Patient Characteristics
3.3. Survival Analysis
3.4. Subgroup Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Biopsy Method (n = 73,644) | ||
---|---|---|---|
FNA (n = 8027) | CNB (n = 65,617) | p-Value | |
Age, years (mean ± SD) | 50.1 ± 10.7 | 50.3 ± 10.5 | 0.127 |
Age, years n (%) | 0.368 | ||
<55 | 5633 (70.2) | 45,923 (70.0) | |
≥55 | 2394 (29.8) | 19,694 (30.0) | |
Tumor size (cm) | 2.5 ± 3.1 | 2.0± 2.9 | <0.001 |
Nodal involvement n (%) | <0.001 | ||
No | 4633 (58.4) | 43,011 (66.2) | |
Yes | 3305 (41.6) | 21,948 (33.8) | |
Unknown | 89 | 658 | |
Stage n (%) | <0.001 | ||
I | 2377 (31.7) | 25,657 (43.6) | |
II | 3512 (46.9) | 23,828 (40.4) | |
III | 1484 (19.8) | 8562 (14.5) | |
IV | 115 (1.5) | 863 (1.5) | |
Palpation n (%) | <0.001 | ||
Yes | 6839 (92.6) | 45,458 (81.7) | |
No | 543 (7.4) | 10,162 (18.3) | |
Unknown | 645 | 9997 | |
Tumor Count n (%) | <0.001 | ||
Single | 6074 (84.7) | 54,384 (87.2) | |
Multiple | 1100 (15.3) | 7515 (12.8) | |
Type n (%) | <0.001 | ||
IDC | 6984 (93.3) | 54,906 (93.2) | |
ILC | 144 (1.9) | 1995 (3.4) | |
Others | 360 (438) | 2009 (3.4) | |
Location n (%) | <0.001 | ||
Lateral | 4530 (62.5) | 38,193 (64.8) | |
Medial | 1742 (24.0) | 14,797 (25.1) | |
Central | 977 (13.5) | 5953 (10.1) | |
Unknown | 2346 | 6674 | |
Histologic grade n (%) | <0.001 | ||
Grades 1 and 2 | 3586 (54.7) | 34,976 (63.9) | |
Grade 3 | 2970 (45.3) | 19,755 (36.1) | |
Unknown | 1471 | 10,886 | |
Surgery | <0.001 | ||
Breast conserving | 3531 (44.0%) | 37,791 (57.6) | |
Mastectomy | 4292 (53.5%) | 26,697 (40.7) | |
Other | 204 (2.5) | 1129 (1.7) | |
BI-RADS category n (%) | <0.001 | ||
0–3 | 187 (3.0) | 1036 (2.0) | |
4 | 369 (6.0) | 6451 (12.5) | |
5 | 5600 (91.0) | 44,282 (85.5) | |
Hormonal receptor n (%) | <0.001 | ||
Positive | 5331 (68.7) | 47,523 (74.2) | |
Negative | 2429 (31.3) | 16,506 (25.8) | |
Unknown | 267 | 1588 | |
HER2 n (%) | <0.001 | ||
Positive | 1667 (28.6) | 13,144 (25.9) | |
Negative | 4158 (71.4) | 37,647 (74.1) | |
Unknown | 4902 | 14,826 |
Univariate Analysis | p-Value | Multivariate Analysis | p-Value | |
---|---|---|---|---|
Age | ||||
<55 | 1 | 1 | ||
≥55 | 1.637 (1.547–1.733) | <0.001 | 1.545 (1.429–1.670) | <0.001 |
Surgery | ||||
Breast conserving | 1 | 1 | ||
Mastectomy | 2.722 (2.558–2.897) | <0.001 | 1.517 (1.386–1.661) | <0.001 |
Others | 4.614 (4.022–5.293) | <0.001 | 2.222 (1.699–2.907) | <0.001 |
Tumor type | ||||
IDC | 1 | 1 | ||
ILC | 0.924 (0.773–1.104) | 0.219 | 1.172 (0.884–1.554) | 0.269 |
Others | 1.677 (1.479–1.901) | 0.060 | 1.316 (1.813–0.983) | 0.039 |
Stage | ||||
I | 1 | 1 | ||
II | 2.264 (2.081–2.464) | <0.001 | 1.751 (1.559–1.967) | <0.001 |
III | 7.334 (6.747–7.971) | <0.001 | 5.192 (4.610–5.846) | <0.001 |
IV | 28.587 (25.488–32.063) | <0.001 | 18.795 (15.629–22.603) | <0.001 |
Location | ||||
Peripheral | 1 | 1 | ||
Central | 1.938 (1.804–2.082) | <0.001 | 1.271 (1.153–1.400) | <0.001 |
Palpation | ||||
No | 1 | 1 | ||
Yes | 2.283 (2.008–2.595) | <0.001 | 1.215 (1.012–1.459) | 0.001 |
Tumor count | ||||
Single | 1 | 1 | ||
Multiple | 1.272 (1.176–1.375) | 0.260 | 1.018 (0.914–1.134) | 0.743 |
Histologic grade | ||||
G 1–2 | 1 | 1 | ||
G 3 | 2.084 (1.964–2.212) | <0.001 | 1.531 (1.411–1.661) | <0.001 |
BI-RADS | ||||
0–3 | 1 | 1 | ||
4 | 0.648 (0.504–0.834) | 0.001 | 1.040 (0.742–1.459) | 0.819 |
5 | 1.125 (0.921–1.375) | 0.250 | 1.146 (0.866–1.516) | 0.342 |
Biopsy | ||||
CNB | 1 | 1 | ||
FNA | 1.415 (1.322–1.515) | <0.001 | 1.123 (1.026–1.228) | 0.012 |
Estrogen Receptor | ||||
Positive | 1 | 1 | ||
Negative | 1.934 (1.828–2.046) | <0.001 | 1.603 (1.483–1.733) | <0.001 |
HER2 | ||||
Negative | 1 | 1 | ||
Positive | 1.261 (1.178–1.349) | <0.001 | 1.100 (1.016–1.191) | 0.019 |
Univariate Analysis | p-Value | Multivariate Analysis | p-Value | |
---|---|---|---|---|
Age | ||||
<55 | 1 | 1 | ||
≥55 | 1.506 (1.419–1.59) | <0.001 | 1.439 (1.332–1.555) | <0.001 |
Surgery | ||||
Breast conserving | 1 | 1 | ||
Mastectomy | 2.771 (2.597–2.957) | <0.001 | 1.509 (1.378–1.652) | <0.001 |
Others | 4.755 (4.127–5.478) | <0.001 | 2.216 (1.772–2.772) | <0.001 |
Tumor type | ||||
IDC | 1 | 1 | ||
ILC | 0.889 (0.738–1.072) | 0.219 | 0.952 (0.744–1.220) | 0.700 |
Others | 1.236 (0.991–1.542) | 0.060 | 1.323 (0.938–1.866) | 0.111 |
Stage | ||||
I | 1 | 1 | ||
II | 2.452 (2.238–2.686) | <0.001 | 2.020 (1.793–2.277) | <0.001 |
III | 8.416 (7.697–9.203) | <0.001 | 6.474 (5.741–7.300) | <0.001 |
IV | 33.503 (29.728–37.757) | <0.001 | 24.706 (20.789–29.359) | <0.001 |
Location | ||||
Peripheral | 1 | 1 | ||
Central | 2.006 (1.863–2.159) | <0.001 | 1.267 (1.153–1.393) | <0.001 |
Palpation | ||||
Yes | 1 | 1 | ||
No | 2.323 (2.031–2.657) | <0.001 | 1.264 (1.053–1.519) | 0.012 |
Tumor count | ||||
Single | 1 | 1 | ||
Multiple | 1.311 (1.210–1.421) | <0.001 | 1.066 (0.960–1.183) | 0.231 |
Histologic grade | ||||
G 1–2 | 1 | 1 | ||
G 3 | 2.187 (2.055–2.326) | <0.001 | 1.576 (1.448–1.715) | <0.001 |
BI-RADS | ||||
0–3 | 1 | 1 | ||
4 | 0.666 (0.513–0.863) | 0.002 | 1.068 (0.754–1.514) | 0.711 |
5 | 1.123 (0.912–1.383) | 0.274 | 1.135 (0.850–1.515) | 0.390 |
Biopsy | ||||
CNB | 1 | 1 | ||
FNA | 1.342 (1.249–1.443) | <0.001 | 1.099 (1.001–1.206) | 0.047 |
Estrogen Receptor | ||||
Positive | 1 | 1 | ||
Negative | 2.003 (1.888–2.124) | <0.001 | 1.668 (1.531–1.816) | <0.001 |
HER2 | ||||
Negative | 1 | 1 | ||
Positive | 1.354 (1.261–1.454) | <0.001 | 1.081 (0.992–1.180) | 0.077 |
CNB | FNA (Univariate) | p-Value | FNA (Multivariate) | p-Value | |
---|---|---|---|---|---|
Age (years) | |||||
<55 | 1 | 1.396 (1.278–1.524) | <0.001 | 1.083 (0.968–1.212) | 0.165 |
≥55 | 1 | 1.410 (1.265–1.572) | <0.001 | 1.146 (0.994–1.321) | 0.061 |
Size | |||||
<2 cm | 1 | 1.385 (1.213–1.582) | <0.001 | 1.134 (0.947–1.358) | 0.171 |
2–4 cm | 1 | 1.216 (1.097–1.349) | <0.001 | 1.073 (0.943–1.220) | 0.283 |
≥4 cm | 1 | 1.257 (1.107–1.428) | <0.001 | 1.135 (0.963–1.338) | 0.132 |
Location | |||||
Peripheral | 1 | 1.386 (1.280–1.501) | <0.001 | 1.066 (0.964–1.179) | 0.213 |
Central | 1 | 1.395 (1.200–1.621) | <0.001 | 1.309 (1.089–1.574) | 0.004 |
BI-RADS | |||||
0–3 | 1 | 1.726 (1.116–2.672) | 0.014 | 1.180(0.667–2.090) | 0.569 |
4 | 1 | 1.629 (1.031–2.575) | 0.037 | 0.881 (0.450–1.723) | 0.711 |
5 | 1 | 1.338 (1.239–1.445) | <0.001 | 1.122 (1.025–1.228) | 0.012 |
Palpable | |||||
Yes | 1 | 1.488 (0.986–2.247) | 0.059 | 0.963 (0.557–1.666) | 0.893 |
No | 1 | 1.302 (1.211–1.400) | <0.001 | 1.224 (1.126–1.331) | <0.001 |
CNB | FNA (Univariate) | p-Value | FNA (Multivariate) | p-Value | |
---|---|---|---|---|---|
Age (years) | |||||
<55 | 1 | 1.336 (1.219–1.463) | <0.001 | 1.045 (0.949–1.151) | 0.374 |
≥55 | 1 | 1.330 (1.181–1.498) | <0.001 | 1.113 (0.981–1.264) | 0.097 |
Size | |||||
<2 cm | 1 | 1.287 (1.113–1.488) | 0.001 | 1.104 (0.950–1.282) | 0.199 |
2–4 cm | 1 | 1.149 (1.030–1.281) | 0.013 | 1.020 (0.912–1.140) | 0.731 |
≥4 cm | 1 | 1.205 (1.057–1.374) | 0.005 | 1.105 (0.966–1.262) | 0.145 |
Location | |||||
Peripheral | 1 | 1.312 (1.206–1.428) | <0.001 | 1.049 (0.961–1.146) | 0.283 |
Central | 1 | 1.323 (1.130–1.547) | <0.001 | 1.201 (1.018–1.416) | 0.030 |
BI-RADS | |||||
0–3 | 1 | 1.708 (1.082–2.698) | 0.022 | 1.221 (0.677–2.199) | 0.507 |
4 | 1 | 1.366 (0.822–2.269) | 0.228 | 1.191 (0.711–1.995) | 0.507 |
5 | 1 | 1.274 (1.175–1.383) | <0.001 | 1.113 (1.023–1.211) | 0.013 |
Palpable | |||||
Yes | 1 | 1.218 (0.751–1.975) | 0.424 | 0.932 (0.557–1.559) | 0.788 |
No | 1 | 1.266 (1.173–1.367) | <0.001 | 1.120 (1.034–1.212) | 0.005 |
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Gwak, H.; Woo, S.S.; Oh, S.J.; Kim, J.Y.; Shin, H.-C.; Youn, H.J.; Chun, J.W.; Lee, D.; Kim, S.H. A Comparison of the Prognostic Effects of Fine Needle Aspiration and Core Needle Biopsy in Patients with Breast Cancer: A Nationwide Multicenter Prospective Registry. Cancers 2023, 15, 4638. https://doi.org/10.3390/cancers15184638
Gwak H, Woo SS, Oh SJ, Kim JY, Shin H-C, Youn HJ, Chun JW, Lee D, Kim SH. A Comparison of the Prognostic Effects of Fine Needle Aspiration and Core Needle Biopsy in Patients with Breast Cancer: A Nationwide Multicenter Prospective Registry. Cancers. 2023; 15(18):4638. https://doi.org/10.3390/cancers15184638
Chicago/Turabian StyleGwak, Hongki, Sang Seok Woo, Se Jeong Oh, Jee Ye Kim, Hee-Chul Shin, Hyun Jo Youn, Jung Whan Chun, Dasom Lee, and Seong Hwan Kim. 2023. "A Comparison of the Prognostic Effects of Fine Needle Aspiration and Core Needle Biopsy in Patients with Breast Cancer: A Nationwide Multicenter Prospective Registry" Cancers 15, no. 18: 4638. https://doi.org/10.3390/cancers15184638
APA StyleGwak, H., Woo, S. S., Oh, S. J., Kim, J. Y., Shin, H. -C., Youn, H. J., Chun, J. W., Lee, D., & Kim, S. H. (2023). A Comparison of the Prognostic Effects of Fine Needle Aspiration and Core Needle Biopsy in Patients with Breast Cancer: A Nationwide Multicenter Prospective Registry. Cancers, 15(18), 4638. https://doi.org/10.3390/cancers15184638