Accuracy of classification of invasive lobular carcinoma on needle core biopsy of the breast

Kalnisha Naidoo; Brooke Beardsley; Pauline J. Carder; Rahul Deb; David Fish; Anne Girling; Sally Hales; Miles Howe; Laura M. Wastall; Sally Lane; Andrew H S Lee; Marianna Philippidou; Cecily Quinn; Tim Stephenson; Sarah E. Pinder

doi:10.1136/jclinpath-2016-203886

Accuracy of classification of invasive lobular carcinoma on needle core biopsy of the breast

Kalnisha Naidoo, Brooke Beardsley, Pauline J. Carder, Rahul Deb, David Fish, Anne Girling, Sally Hales, Miles Howe, Laura M. Wastall, Sally Lane, Andrew H S Lee, Marianna Philippidou, Cecily Quinn, Tim Stephenson, Sarah E. Pinder^*

^*Corresponding author for this work

Comprehensive Cancer Centre

Research output: Book/Report › Report › peer-review

1 Citation (Scopus)

Abstract

Although the UK National Institute for Health and Care Excellence guidelines recommend that in patients with biopsy-proven invasive lobular carcinoma (ILC), preoperative MRI scan is considered, the accuracy of diagnosis of ILC in core biopsy of the breast has not been previously investigated. Eleven pathology laboratories from the UK and Ireland submitted data on 1112 cases interpreted as showing features of ILC, or mixed ILC and IDC/no special type (NST)/other tumour type, on needle core biopsy through retrieval of histology reports. Of the total 1112 cases, 844 were shown to be pure ILC on surgical excision, 154 were mixed ILC plus another type (invariably ductal/NST) and 113 were shown to be ductal/NST. Of those lesions categorised as pure ILC on core, 93% had an element of ILC correctly identified in the core biopsy sample and could be considered concordant. Of cores diagnosed as mixed ILC plus another type on core, complete agreement between core and excision was 46%, with 27% cases of pure ILC, whilst 26% non-concordant. These data indicate that there is not a large excess of expensive MRIs being performed as a result of miscategorisation histologically.

Original language	English
Publisher	BMJ publishing
DOIs	https://doi.org/10.1136/jclinpath-2016-203886
Publication status	E-pub ahead of print - 10 Aug 2016

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Naidoo, K., Beardsley, B., Carder, P. J., Deb, R., Fish, D., Girling, A., Hales, S., Howe, M., Wastall, L. M., Lane, S., Lee, A. H. S., Philippidou, M., Quinn, C., Stephenson, T., & Pinder, S. E. (2016). Accuracy of classification of invasive lobular carcinoma on needle core biopsy of the breast. BMJ publishing. Advance online publication. https://doi.org/10.1136/jclinpath-2016-203886

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title = "Accuracy of classification of invasive lobular carcinoma on needle core biopsy of the breast",

abstract = "Although the UK National Institute for Health and Care Excellence guidelines recommend that in patients with biopsy-proven invasive lobular carcinoma (ILC), preoperative MRI scan is considered, the accuracy of diagnosis of ILC in core biopsy of the breast has not been previously investigated. Eleven pathology laboratories from the UK and Ireland submitted data on 1112 cases interpreted as showing features of ILC, or mixed ILC and IDC/no special type (NST)/other tumour type, on needle core biopsy through retrieval of histology reports. Of the total 1112 cases, 844 were shown to be pure ILC on surgical excision, 154 were mixed ILC plus another type (invariably ductal/NST) and 113 were shown to be ductal/NST. Of those lesions categorised as pure ILC on core, 93% had an element of ILC correctly identified in the core biopsy sample and could be considered concordant. Of cores diagnosed as mixed ILC plus another type on core, complete agreement between core and excision was 46%, with 27% cases of pure ILC, whilst 26% non-concordant. These data indicate that there is not a large excess of expensive MRIs being performed as a result of miscategorisation histologically.",

author = "Kalnisha Naidoo and Brooke Beardsley and Carder, {Pauline J.} and Rahul Deb and David Fish and Anne Girling and Sally Hales and Miles Howe and Wastall, {Laura M.} and Sally Lane and Lee, {Andrew H S} and Marianna Philippidou and Cecily Quinn and Tim Stephenson and Pinder, {Sarah E.}",

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AU - Naidoo, Kalnisha

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AU - Deb, Rahul

AU - Fish, David

AU - Girling, Anne

AU - Hales, Sally

AU - Howe, Miles

AU - Wastall, Laura M.

AU - Lane, Sally

AU - Lee, Andrew H S

AU - Philippidou, Marianna

AU - Quinn, Cecily

AU - Stephenson, Tim

AU - Pinder, Sarah E.

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N2 - Although the UK National Institute for Health and Care Excellence guidelines recommend that in patients with biopsy-proven invasive lobular carcinoma (ILC), preoperative MRI scan is considered, the accuracy of diagnosis of ILC in core biopsy of the breast has not been previously investigated. Eleven pathology laboratories from the UK and Ireland submitted data on 1112 cases interpreted as showing features of ILC, or mixed ILC and IDC/no special type (NST)/other tumour type, on needle core biopsy through retrieval of histology reports. Of the total 1112 cases, 844 were shown to be pure ILC on surgical excision, 154 were mixed ILC plus another type (invariably ductal/NST) and 113 were shown to be ductal/NST. Of those lesions categorised as pure ILC on core, 93% had an element of ILC correctly identified in the core biopsy sample and could be considered concordant. Of cores diagnosed as mixed ILC plus another type on core, complete agreement between core and excision was 46%, with 27% cases of pure ILC, whilst 26% non-concordant. These data indicate that there is not a large excess of expensive MRIs being performed as a result of miscategorisation histologically.

AB - Although the UK National Institute for Health and Care Excellence guidelines recommend that in patients with biopsy-proven invasive lobular carcinoma (ILC), preoperative MRI scan is considered, the accuracy of diagnosis of ILC in core biopsy of the breast has not been previously investigated. Eleven pathology laboratories from the UK and Ireland submitted data on 1112 cases interpreted as showing features of ILC, or mixed ILC and IDC/no special type (NST)/other tumour type, on needle core biopsy through retrieval of histology reports. Of the total 1112 cases, 844 were shown to be pure ILC on surgical excision, 154 were mixed ILC plus another type (invariably ductal/NST) and 113 were shown to be ductal/NST. Of those lesions categorised as pure ILC on core, 93% had an element of ILC correctly identified in the core biopsy sample and could be considered concordant. Of cores diagnosed as mixed ILC plus another type on core, complete agreement between core and excision was 46%, with 27% cases of pure ILC, whilst 26% non-concordant. These data indicate that there is not a large excess of expensive MRIs being performed as a result of miscategorisation histologically.

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Accuracy of classification of invasive lobular carcinoma on needle core biopsy of the breast

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