Core needle biopsy for diagnosis of extremity soft tissue sarcoma Journal Article


Authors: Heslin, M. J.; Lewis, J. J.; Woodruff, J. M.; Brennan, M. F.
Article Title: Core needle biopsy for diagnosis of extremity soft tissue sarcoma
Abstract: Background: Classic teaching has advocated the use of open biopsy to diagnose and grade extremity soft-tissue sarcoma. Reported advantages of core needle biopsy include the minimal morbidity, cost, and time. The perceived disadvantage has been diagnostic inaccuracy. The objective of this study was to compare the diagnostic accuracy of core needle biopsy to incisional or frozen section biopsy for primary extremity masses suspicious for soft-tissue sarcoma. Methods: Patients presenting with extremity masses were identified from our prospective soft-tissue sarcoma database (malignant) and from the clinical information center (benign) between January 1, 1990, and December 31, 1995. Biopsy and subsequent resection data were collected from the pathologic records. Results: During this time, 164 primary extremity soft-tissue masses were evaluated before any biopsy. As the initial diagnostic approach, there were 60 core needle, 44 incisional, 36 frozen section, and 26 excisional biopsies. Two patients underwent two biopsy procedures. Ninety-three percent of the specimens obtained at core needle biopsy were adequate to make a diagnosis. Of the adequate core needle biopsy specimens, 95%, 88% and 75% correlated with the final resection diagnosis for malignancy, grade, and histologic subtype, respectively. Of the frozen section biopsy specimens, 94% were adequate, and accurate diagnostic results of malignancy were obtained with 88%. However, only 62% and 47% were correct for grade and histologic subtype, respectively, which was significantly different than the results obtained with incisional biopsy. The false-negative and false-positive rates for core needle biopsy were 5% and 0% for malignancy. Two core needle biopsy specimens graded low were found to be high, and one core needle biopsy specimen graded high was subsequently found to be low on final resection. Conclusions: When read by an experienced pathologist, the results of core needle biopsy provide accurate diagnostic information for malignancy and grade. Adequate core needle biopsy obviates the need for open biopsy and can be used for rational treatment planning. In the absence of adequate tissue, open biopsy is required. Published by Lippincott-Raven Publishers © 1997 The Society of Surgical Oncology, Inc.
Keywords: prospective study; sensitivity and specificity; prospective studies; biopsy; sarcoma; limb; biopsy, needle; needle biopsy; prediction and forecasting; predictive value of tests; extremities; soft tissue neoplasms; soft tissue tumor; core needle; humans; human; article
Journal Title: Annals of Surgical Oncology
Volume: 4
Issue: 5
ISSN: 1068-9265
Publisher: Springer  
Date Published: 1997-07-01
Start Page: 425
End Page: 431
Language: English
PUBMED: 9259971
PROVIDER: scopus
DOI: 10.1007/BF02305557
DOI/URL:
Notes: Article -- Presented at the 49th Annual Cancer Symposium of The Society of Surgical Oncology that took place 1996 Mar 21-24 in Atlanta, GA -- Export Date: 17 March 2017 -- Source: Scopus
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  1. Murray F Brennan
    1059 Brennan
  2. Jonathan J Lewis
    109 Lewis
  3. James M Woodruff
    162 Woodruff
  4. Martin J. Heslin
    30 Heslin