ASSESSMENT OF ACCURACY OF INCISIONAL AND NEEDLE BIOPSY IN SOFT-TISSUE TUMORS IN A BRAZILIAN CENTER OF REFERENCE

Delocco, Bruna Canteri; Fiorelli, Bruno de Oliveira; Abrantes, Igor Borges; Luz, Eliane dos Santos; Lopes, Ana Cristina de Sá; Meohas, Walter

doi:10.1590/1413-785220253304e290125

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Original Article/Orthopedic Oncology • Acta Ortop Bras 33 (4) • 2025 • https://doi.org/10.1590/1413-785220253304e290125 linkcopy

ASSESSMENT OF ACCURACY OF INCISIONAL AND NEEDLE BIOPSY IN SOFT-TISSUE TUMORS IN A BRAZILIAN CENTER OF REFERENCE

AVALIAÇÃO DA ACURÁCIA DA BIÓPSIA INCISIONAL E POR AGULHA NOS TUMORES DE PARTES MOLES EM UM CENTRO DE REFERÊNCIA BRASILEIRO

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives: To assess the accuracy of incisional biopsies (IB) and needle biopsies (NB) in soft-tissue tumors treated at a Brazilian center of reference, as well as the variables related to the demographic profile and treatment established.

Methods: A retrospective, descriptive and observational study was conducted with patients with malignant soft tissue tumoral lesions, of indeterminate and intermediary malignancy, subjected to IB or NB at the institution from January 2010 to December 2019.

Results: 114 biopsies were performed in soft-tissue tumors of malignant lesions, of indeterminate and intermediary malignancy; of these 90 biopsies, 61 (67.7%) were IB and 29 (25.4%) were NB. It was necessary to perform a new collection in 5 cases among the NB (17.2%) and 1 case among the IB (1.6%). The IB accuracy was 83.6, while NB was 62.1. Of the 18 patients subjected to surgical treatment with radical margin, 7 were initially subjected to NB (36.8%) and 9 to IB (17.3%).

Conclusion: Despite the advantages inherent to the percutaneous procedure of NB, IB must still be considered a diagnostic option in soft tissue tumors with high heterogeneity and degree of necrosis. Level of Evidence III; Diagnostic Studies - Investigating a Diagnostic Test.

Keywords:
Soft Tissue Neoplasms; Biopsy; Diagnosis; Medical Oncology; Sarcoma

Variable	% (n)
Sex
Female	52.6% (n = 60)
Male	47.4% (n = 54)
Ethnicity
White	53.5% (n = 61)
Mixed race	32.5% (n = 37)
Black	16% (n = 14)
Age group
Less than 20 years	13.2% (n = 15)
20 – 40 years	20.2% (n = 23)
40 – 60 years	33.3% (n = 38)
More than 60 years	33.3% (n = 38)

Variable	% (n)
Type of initial biopsy
Needle	25.4% (n = 29)
Incision	67.8% (n = 61)
Excisional1	10.5% (n = 12)
Carried out at another institution1	10.5% (n = 12)
Was it necessary to repeat the biopsy?
Yes	6.1% (n = 7)2
No	93.9% (n = 107)
What technique was used in the second biopsy?
Incision	71.4% (n = 5)
Excisional	28.6% (n = 2)
Technique used to define the diagnosis
Histopathological	46.5% (n = 53)
Immunohistochemical	53,5% (n = 61)
Proposed initial treatment
Surgical	71.9% (n = 82)
Referred to another service3	28.1% (n = 32)

Variable	% (n)
Type of biopsy 1
Incision biopsy	67.8% (n = 61)
Biopsy by needle	32.2% (n = 29)
Unconcluding biopsies that needed to be repeated
Incision biopsy	1.6% (n = 1)
Biopsy by needle	17.2% (n = 5)
Biopsies that had initial FHR altered
Incision biopsy	16.4% (n = 10)
Biopsy by needle	37.9% (n = 11)

Accuracy	%
Type of biopsy
Incision biopsy	83.6%
Biopsy by needle	62.1%

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[TFN1] ¹
Patients referred to this service after performing the biopsy in another institution and patients undergoing BE were excluded from the study.

[TFN2] ²
One of the biopsies that needed to be repeated was a biopsy performed in another institution and, therefore, was excluded from the final accuracy analysis.

[TFN3] ³
Patients referred to treatment with chemotherapy or radiotherapy in another institution.