(1) Background: Breast core needle biopsy (CNB) is preferred over fine needle aspiration (FNA) as it has higher sensitivity and specificity and enables immunohistochemical evaluation. However, breast FNA remains widely used because of its low cost, minimally invasive nature, and quick results. Studies analyzing the effects of each test on the prognoses of patients with breast cancer are scarce and controversial, and the criteria for test selection remain unknown. (2) Methods: This study included adult female patients who underwent breast cancer surgery at 102 general hospitals. The trend of breast biopsies over time was analyzed, and the prognoses of patients with breast cancer who underwent CNB and FNA were compared. (3) Results: This study included 73,644 patients who underwent FNA (n= 8027) and CNB (n= 65,617). A multivariate Cox regression analysis showed that patients diagnosed using FNA had significantly worse overall survival (OS) and breast-cancer-specific survival (BCSS) than those diagnosed using CNB. In the subgroup analysis, patients with breast imaging reporting and data system (BI-RADS) 5 lesions, palpable tumors, or centrally located tumors had significantly worse OS and BCSS with FNA than with CNB. (4) Conclusions: CNB should be performed preferentially instead of FNA in patients with BI-RADS 5 lesions and nonpalpable or centrally located tumors.
（1）背景：与细针穿刺活检（FNA）相比，乳腺粗针穿刺活检（CNB）因其更高的敏感性和特异性，并能进行免疫组化评估而更受青睐。然而，由于成本低、创伤小且结果快速，乳腺FNA仍被广泛使用。分析这两种检查对乳腺癌患者预后影响的研究较少且存在争议，检查选择的标准尚不明确。（2）方法：本研究纳入了在102家综合医院接受乳腺癌手术的成年女性患者。分析了乳腺活检随时间变化的趋势，并比较了接受CNB和FNA的乳腺癌患者的预后。（3）结果：本研究共纳入73,644例患者，其中接受FNA者8,027例，接受CNB者65,617例。多变量Cox回归分析显示，与通过CNB诊断的患者相比，通过FNA诊断的患者总生存期（OS）和乳腺癌特异性生存期（BCSS）均显著更差。在亚组分析中，对于乳腺影像报告和数据系统（BI-RADS）5类病变、可触及肿瘤或中心位置肿瘤的患者，FNA组的OS和BCSS均显著差于CNB组。（4）结论：对于BI-RADS 5类病变以及不可触及或中心位置的肿瘤患者，应优先选择CNB而非FNA。
肿瘤(癌症)患者之家