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Assessment accuracy of core needle biopsy for hormone receptors in breast cancer: a meta-analysis

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Abstract

The concordance of hormone receptors (HR) status identified by core needle biopsy (CNB) compared with excisional biopsy (EB) has been widely reported, but results were extremely variable and underpowered. To derive a more precise estimation of assessment accuracy of CNB for HR in breast cancer, we conducted a meta-analysis of all eligible studies comparing concordance or disconcordance between CNB and EB for HR status. Eligible articles were identified by search of databases including PubMed, Web of Science, EMBASE, and Chinese Biomedical Literature database for the period up to November 2011, and the reference lists of identified studies, relevant reviews, meta-analyses, and abstracts from recent conference proceedings were reviewed as a augmented searching. Finally, a total of 21 articles involving 2,450 patients for estrogen receptor (ER) and 2,448 patients for progesterone receptor (PR) were included and analyzed in this analysis. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies checklist. The overall aggrement between CNB and EB were 92.8 % for ER (κ = 0.78) and 85.2 % for PR (κ = 0.66), indicating a good agreement in PR and a better result in ER. The pooled sensitivity and specificity were 97.3 % (95 % CI 96.0–98.2) and 82.0 % (95 % CI 68.2–90.6) for ER, and the corresponding values for PR were 92.3 % (95 % CI 88.2–95.1) and 76.5 % (95 % CI 64.6–85.3), respectively. The pooled positive likelihood ratios was 5.39 % (95 % CI 2.92–9.97) and the negative likelihood ratios was 0.03 % (95 % CI 0.02–0.05) for ER, the corresponding values for PR were 3.93 % (95 % CI 2.53–6.11) and 0.10 % (95 % CI 0.07–0.16), respectively. In summary, although a good agreement was observed between CNB and EB for both ER and PR, we still suggest that negative HR testing results should be interpreted with caution or repeated on EB.

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Acknowledgments

We are grateful to Dr. KuSang Kim from Department of Surgery, Seoul National University Bundang Hospital, Seoul, Korea for providing data from their study [12].

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Authors and Affiliations

  1. Breast Disease Center, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Chongqing, 400038, China

    Shichao Li, Xinhua Yang, Yi Zhang, Linjun Fan, Fan Zhang, Li Chen, Yan Zhou, Xianchun Chen & Jun Jiang

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  1. Shichao Li
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Correspondence to Jun Jiang.

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Shichao Li and Xinhua Yang contributed equally to this article and should be considered as co-first authors.

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Li, S., Yang, X., Zhang, Y. et al. Assessment accuracy of core needle biopsy for hormone receptors in breast cancer: a meta-analysis. Breast Cancer Res Treat 135, 325–334 (2012). https://doi.org/10.1007/s10549-012-2063-z

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