Selection of Breast Core Biopsy Specimens for Tissue Bio-Repository
Daniel G Rosen, Lavinia P Middleton, Wei T Yang, Aysegul A Sahin. Baylor College of Medicine, Houston, TX; MD Anderson Cancer Center, Houston, TX
Background: Neoadjuvant therapy has been widely adopted in breast cancer patients. With the advent and success rate of such practice the amount of tissue that is available for further testing in subsequent resection specimens can be scant. Furthermore, the tumor morphology and biomarker expression may be altered due to the previous exposure of such therapy agents. Hence, some institutions are considering the acquisition of an additional core needle biopsy at the time of the procedure. This additional fragment of tissue may be used for future maker testing if the patient is enrolled in a research protocol not affecting the diagnostic material. Tissue bio-repositories represent an invaluable resource for research studies and provide a tissue reservoir for future tests. Therefore, tissue samples collected and stored during the initial diagnostic procedure has been suggested. The aim of this study is to determine the impact of selecting random tissue cores for breast cancer bio-repository.
Design: A total 988 ultrasound guided core biopsies from 242 specimens corresponding to 224 patients between 2008 and 2009 were examined. Each core was examined percentage of tumor present and diagnostic adequacy. Only specimens with presence of invasive carcinoma were included for this analysis. Cores with < 10% of tumor were considered as low cellularity for bio-repository.
Results: The average number of cores per specimen was 4 (range 2 to 8) with an average core size length of 0.95 cm (range 0.1 cm to 3.5 cm). In addition, 3 of the 242 specimens showed fragmented core pieces ranging from 0.1 to 0.9 cm in aggregate. Needle size ranged from 21 to 12 gauge. In 66 specimens (41%) there was at least 1 core with < 10% tumor cellularity. In 95 specimens (59%) all cores had >10% of tumor cellularity and in 12 specimens all cores showed < 10% tumor cellularity. A total of 789 cores (80%) were considered of good diagnostic quality, 185 cores (19%) adequate with minor diagnostic artifacts, and 14 cores (1%) insufficient for diagnosis. The later were considered as insufficient for diagnosis due to scant tumor present on 3 cases.
Conclusions: If extra core biopsy will be used for future studies a quality control of tissue such as touch imprint, frozen sections, or other innovative techniques should be utilized in order to increase the chance of obtaining tissue with adequate tumor.
At the present time, laboratory techniques that use paraffin embedded tissue for testing may be a better alternative until these issues are resolved.
Future studies are guaranteed.
Wednesday, March 21, 2012 1:00 PM
Poster Session VI # 2, Wednesday Afternoon