Comparison of the prognostic impact of core needle biopsy and intraoperative excisional biopsy in breast cancer: A single-center retrospective cohort study

Core needle biopsy (CNB) and intraoperative excisional biopsy (IEB) are currently the 2 major methods for diagnosing breast cancer in China. The purpose of this study was to compare the prognostic impact of CNB and IEB in breast cancer patients. We retrospectively analyzed breast cancer patients who underwent surgery at the Department of Breast and Thyroid Surgery of the Provincial Hospital Affiliated to Shandong First Medical University between January 2011 and January 2021. Clinicopathological characteristics, disease-free survival (DFS) and overall survival (OS) were compared between the CNB and IEB groups. From January 2011 to January 2021, a total of 2330 newly diagnosed breast cancer patients were enrolled in this retrospective study. The log-rank survival analysis revealed no significant difference in OS between the 2 groups (P = .156), but the CNB group had significantly worse DFS (P = .002). In the subgroup analysis, for the HR+/HER2- subtype, both OS and DFS were significantly lower in the CNB subgroup than in the IEB subgroup. Multivariate survival analyses revealed that CNB was independently associated with shorter DFS (HR: 1.729, 95% CI: 1.228-2.434, P = .002). Among HR+/HER2- patients, CNB was a significant independent risk factor and indicated shorter OS (HR: 1.990, 95% CI: 1.023-3.874, P = .043) and shorter DFS (HR: 2.284, 95% CI: 1.413-3.693, P = .001) than IEB. This study suggests that CNB may be associated with a poorer prognosis in certain breast cancer subtypes, particularly HR+/HER2-, compared to IEB. These findings highlight the need for further clinical investigation to optimize biopsy strategies in breast cancer diagnosis.