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Rev. Col. Bras. Cir ; 41(1): 7-10, Jan-Feb/2014.
Article in English | LILACS | ID: lil-707260

ABSTRACT

OBJECTIVE: to evaluate the accuracy of frozen section histopathology from fragments of tissue obtained by percutaneous core needle biopsy of palpable tumors in the diagnosis of breast cancer. METHODS: a cohort study was performed on 57 patients with palpable tumors and suspected breast cancer undergoing percutaneous thick needle core biopsy. The fragments were analyzed by the same pathologist. RESULTS: frozen section diagnosed 16 benign cases (28.6%) and 40 malignant (71.4%), whereas paraffin showed that 15 were benign (26.8%) and 41 malignant (73.2%). Histopathological examinations were concordant in 55 cases and there was one false-negative (6.2%). Statistics rates were: negative predictive value of 93.8%, positive predictive value of 100%, no false-positive (0%), one false negative (6.2%), specificity of 100%, sensitivity of 97 6%; observed agreement = 98.2%; expected agreement = 59.9%, Kappa = 0.955 [ 95% CI = 0.925-0.974, p < 0.01 ]. CONCLUSIONS: frozen section histopathological findings showed excellent correlation with the findings by the technique in paraffin in the fragments of palpable breast tumors obtained by thick needle percutaneous core biopsy (98.2% accuracy). Therefore, in these patients, it was possible to anticipate the diagnosis, staging and the breast cancer treatment planning. .


OBJETIVO: avaliar a acurácia do exame histopatológico por congelação em fragmentos de tecido obtidos por biópsia percutânea com agulha grossa no diagnóstico do câncer de mama em tumores palpáveis. MÉTODOS: foi realizado estudo de coorte em 57 pacientes portadoras de tumores palpáveis e suspeitos de câncer de mama, submetidas à biópsia por punção percutânea com agulha grossa. Os fragmentos foram analisados pela mesma anatomopatologista. RESULTADOS: a congelação diagnosticou 16 casos benignos (28,6%) e 40 malignos (71,4%), enquanto a parafina revelou que 15 eram benignos (26,8%) e 41 malignos (73,2%). Os exames histopatológicos foram concordantes em 55 casos e houve um falso-negativo (6,2%). As taxas estatísticas foram: valor preditivo negativo de 93,8%, valor preditivo positivo de 100%, nenhum falso-positivo (0%), um falso-negativo (6,2%), especificidade de 100%; sensibilidade de 97,6%; concordância observada = 98,2%; concordância esperada = 59,9%; Kappa = 0,955 [IC 95% = 0,925 a 0,974, p<0,01]. CONCLUSÃO: Os achados histopatológicos por congelação apresentaram excelente correlação com os achados pela técnica em parafina nos fragmentos de tumores mamários palpáveis obtidos por punção percutânea com agulha grossa (acurácia de 98,2%). Logo, nestas pacientes, foi possível antecipar o diagnóstico, o estadiamento e a programação terapêutica do câncer de mama. .


Subject(s)
Female , Humans , Breast Neoplasms/pathology , Frozen Sections , Biopsy, Needle , Cohort Studies , Predictive Value of Tests , Reproducibility of Results
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