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ACCURACY OF TRUCUT AND INCISION BIOPSY IN THE DIAGNOSIS OF SOFT TISSUE MASSES



Abstract

Introduction: The Literature is divisive in regards to the superiority of Core versus Incision biopsy in the diagnosis of Soft Tissue Tumour. The Aim of the study is to compare the accuracy of Trucut biopsy and open Incision Biopsy.

Methods: This was a retrospective review of case notes and pathology records. Between January 2006 and June 2007, 34 Trucut biopsies were performed without imaging guidance in an outpatient setting and 57 incision biopsies were performed as an inpatient on patients referred with a soft tissue mass to our service. In each case the accuracy of biopsy in providing a diagnostic sample, in determining the tumour type and the histological grade of tumour were calculated. For each biopsy method we compared the diagnosis after biopsy with the final diagnosis after excision. The proportion of diagnostic biopsies was calculated, as were the sensitivity and specificity of each technique in providing a diagnosis. Fisher’s exact test was used to test for differences in the techniques.

Results: In this series there were 41 soft tissue sarcomas, 8 metastatic adenocarcinoma soft tissue deposits, 7 lymphomas, 1 non soft tissue sarcoma, 32 benign soft tissue tumours and 1 infection. 33/34 Trucut biopsies and 55/57 open biopsies provided the final histological diagnosis (p=1). There was no statistical difference between the techniques in the accuracy of identifying the type and grade of soft tissue sarcoma

Discussion: Trucut biopsy is equivalent to incision biopsy in its accuracy of diagnosing soft tissue tumours. Biopsy in an outpatient setting for appropriate tumours is cost effective and likely shortens the time to diagnosis. Our results are comparable to published data from other centres.

Correspondence should be addressed to BOOS c/o British Orthopaedic Association, 35-43 Lincoln’s Inn Fields, London WC2A 3PE, England