Clinicopathological Features and Disease Outcome in Breast Cancer Patients with Hormonal Receptor Discordance between Core Needle Biopsy and Following Surgical Sample.

BACKGROUND: There are limited data about how to manage patients with discordant hormonal receptor (HR) status between core needle biopsy (CNB) and following surgical sample (FSS). This study aimed to evaluate clinicopathological features and disease outcome for these HR discordance patients. PATIENTS AND METHODS: Invasive breast cancer patients with paired HR between CNB and FSS were retrospectively analyzed, being classified into three groups: HR positive, HR negative, and HR discordance. Patient characteristics, treatment decisions, and disease outcome were compared among above groups. RESULTS: A total of 1710 patients (1233 HR positive, 417 HR negative, and 60 HR discordance patients) were enrolled. Compared with the HR positive group, HR discordance patients were associated with more human epidermal growth factor receptor 2 positivity (P < 0.001) and higher Ki67 level (P = 0.001) tumors. The fraction of patients receiving adjuvant chemotherapy was 95.0% and 93.8% in the HR discordance or HR negative groups, much higher than in the HR positive group (66.7%, P < 0.001). Of 60 HR discordance patients, 34 (56.7%) received adjuvant endocrine therapy. The 5-year disease-free survival (DFS) rate was 90.4% for HR discordant patients, showing no statistical difference compared with HR positive (87.0%, P = 0.653) or HR negative (83.2%, P = 0.522) groups. For HR discordance patients, there was no difference in DFS between patients who received adjuvant endocrine therapy or not (P = 0.259). CONCLUSIONS: HR discordance patients had similar tumor characteristics, adjuvant chemotherapy treatment, and DFS compared with HR negative patients. The benefit of endocrine therapy in these HR discordance patients is uncertain and deserves further clinical evaluation.

Safety of Percutaneous Biopsy for Hepatic Angiosarcoma: Results of a Multicenter Korean Survey.

PURPOSE: To evaluate the incidence of severe bleeding and mortality associated with percutaneous biopsy for hepatic angiosarcoma in a multicenter retrospective cohort. MATERIALS AND METHODS: A retrospective review of 33 patients with biopsy-proven hepatic angiosarcoma (29 male; median age, 57 y; age range, 24-96 y) was performed at seven tertiary academic hospitals between January 1998 and March 2015. The mean maximum tumor size was 5.5 cm (range, 1.7-20 cm). An 18-gauge automated cutting biopsy needle was used with a freehand technique in all patients who underwent ultrasonography-guided percutaneous core needle biopsy on an inpatient basis. The incidences of severe bleeding and procedure-related mortality were evaluated per Society of Interventional Radiology (SIR) guidelines. RESULTS: There was a mean of 2.8 needle passes per patient during the procedure (range, 1-6). The overall incidence of severe bleeding events (SIR grade C/D) was 9.1% (3 of 33). Two patients were managed with blood transfusion, and one patient underwent embolization for bleeding control. No other major complications were encountered. There were no cases of mortality associated with the biopsy. CONCLUSIONS: Severe bleeding was not a frequent complication after percutaneous biopsy for hepatic angiosarcoma. The majority of bleeding complications could be controlled with conservative management.

Diagnostic Accuracy and Safety of CT-Guided Percutaneous Transthoracic Needle Biopsies: 14-Gauge versus 22-Gauge Needles.

PURPOSE: To compare the diagnostic accuracy and safety of a 14-gauge core needle versus a 22-gauge fine needle in the evaluation of thoracic lesions by CT-guided percutaneous transthoracic needle biopsy (TTNB). MATERIALS AND METHODS: Medical charts of all patients who underwent CT-guided percutaneous transthoracic core-needle biopsies (CNBs) with a 14-gauge Spirotome device (99 patients, 102 procedures) and fine-needle biopsies (FNBs) with a 22-gauge Rotex needle (92 patients, 102 procedures) between 2007 and 2013 at a single academic institution were retrospectively reviewed. Variables that could influence diagnostic accuracy and safety were collected. RESULTS: The overall and cancer-specific diagnostic accuracy rates were 90% and 94%, respectively, with CNB, versus 82% and 89% with FNB. Precise cancer type/subtype was provided by 97% of CNBs versus 65% of FNBs (P < .001). In patients with lung cancer considered for targeted therapy, biomarker analyses were feasible in 80% of CNBs versus 0% of FNBs (P < .001). The rate of pneumothorax was significantly higher with CNB versus FNB (31% vs 19%; P = .004), but chest tube insertion rates were similar (10% vs 11%, respectively). Major bleeding complications occurred in 1% of CNBs versus 2% of FNBs and were associated with one death in the CNB group. CONCLUSIONS: Percutaneous transthoracic CNB with a 14-gauge Spirotome needle provided better characterization of cancer lesions and allowed biomarker analyses without a significant increase in major procedural complications.