Diagnostic value of fine-needle aspiration biopsy for breast mass: a systematic review and meta-analysis

BMC Cancer

Research Article

Jian-Lun Liu¹  Ying-Hua Yu¹  Wei Wei¹ 

[1] Departmant of Breast Surgery of Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, P.R. China;

关键词: Breast Lesion;    Negative Likelihood Ratio;    Positive Likelihood Ratio;    Diagnostic Odds Ratio;    Breast Cyst;   

DOI  :  10.1186/1471-2407-12-41

 received in 2011-05-12, accepted in 2012-01-25,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundFine-needle aspiration biopsy (FNAB) of the breast is a minimally invasive yet maximally diagnostic method. However, the clinical use of FNAB has been questioned. The purpose of our study was to establish the overall value of FNAC in the diagnosis of breast lesions.MethodsAfter a review and quality assessment of 46 studies, sensitivity, specificity and other measures of accuracy of FNAB for evaluating breast lesions were pooled using random-effects models. Summary receiver operating characteristic curves were used to summarize overall accuracy. The sensitivity and specificity for the studies data (included unsatisfactory samples) and underestimation rate of unsatisfactory samples were also calculated.ResultsThe summary estimates for FNAB in diagnosis of breast carcinoma were as follows (unsatisfactory samples was temporarily exluded): sensitivity, 0.927 (95% confidence interval [CI], 0.921 to 0.933); specificity, 0.948 (95% CI, 0.943 to 0.952); positive likelihood ratio, 25.72 (95% CI, 17.35 to 28.13); negative likelihood ratio, 0.08 (95% CI, 0.06 to 0.11); diagnostic odds ratio, 429.73 (95% CI, 241.75 to 763.87); The pooled sensitivity and specificity for 11 studies, which reported unsatisfactory samples (unsatisfactory samples was considered to be positive in this classification) were 0.920 (95% CI, 0.906 to 0.933) and 0.768 (95% CI, 0.751 to 0.784) respectively. The pooled proportion of unsatisfactory samples that were subsequently upgraded to various grade cancers was 27.5% (95% CI, 0.221 to 0.296).ConclusionsFNAB is an accurate biopsy for evaluating breast malignancy if rigorous criteria are used. With regard to unsatisfactory samples, futher invasive procedures are required in order to minimize the chance of a missed diagnosis of breast cancer.

【 授权许可】

Unknown   
© Yu et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.