Meta‐analysis of the concordance of histological grade of breast cancer between core needle biopsy and surgical excision specimen. BJS 2016; 103: 644-655.
Published: 15th March 2016
Authors: F. M. Knuttel, G. L. G. Menezes, P. J. van Diest, A. J. Witkamp, M. A. A. J. van den Bosch, H. M. Verkooijen et al.
With the increasing use of neoadjuvant chemotherapy and minimally invasive ablative therapy in breast cancer, pretreatment assessment of tumour grade on core needle biopsy (
Following the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (
Thirty‐four articles were included in the systematic review (6029 patients) and 33 in the meta‐analysis (4980 patients). Pooled agreement and κ were 71·1 (95 per cent c.i. 68·8 to 73·3) per cent and 0·54 (0·50 to 0·58) respectively. Underestimation and overestimation occurred in 19·1 (17·1 to 21·3) and 9·3 (7·7 to 11·4) per cent respectively. Meta‐regression showed associations between agreement of histological type (positive association) and proportion of patients with oestrogen receptor‐positive disease (negative association) and grade agreement.
Grading on CNB corresponds moderately with grading based on excision specimens, with underestimation in about one in five patients. Incorrect CNB tumour grading has limited clinical implications, as multiple factors influence decision‐making for adjuvant systemic therapy.Full text
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