Fourteen‐gauge ultrasonographically guided large‐core needle biopsy of breast masses.

Abstract

Objective. Large-core needle biopsy of the breast can be performed with stereotactic or ultrasonographic guidance. However, ultrasonographically guided large-core needle biopsy has notable advantages, including the absence of ionizing radiation, increased patient comfort, and greater cost-effectiveness. The purpose of this study was to evaluate the accuracy of ultrasonographically guided large-core needle biopsy for the diagnosis of breast cancer in palpable and nonpalpable breast masses. Methods. The study was a retrospective review of consecutive ultrasonographically guided large-core needle biopsies for indeterminate breast masses. A total 424 ultrasonographically guided core biopsies were performed in 367 patients with 1 or more breast masses. Ultrasonographically guided core biopsy was performed with a 14-gauge spring-loaded needle and a freehand technique. Correlation of ultrasonographically guided core biopsy pathologic findings with subsequent surgical pathologic findings or long-term imaging followup was performed. Results. Of 424 indeterminate breast lesions for which histopathologic findings were obtained by ultrasonographically guided core biopsy, 234 cancers were diagnosed. Twenty-eight additional lesions had either questionable but not definitively malignant pathologic features (n = 11) or radiologic-pathologic discordance (n = 17) and were surgically excised. Of these, 8 additional cancers were diagnosed. Patients or surgeons chose excision of 41 additional lesions that were benign on ultrasonographically guided core biopsy. No cancer was found in these surgical specimens. One additional cancer was diagnosed at a 6-month imaging follow-up because of interval growth. On the basis of surgical and long-term imaging follow-up, the sensitivity of ultrasonographically guided core biopsy for the diagnosis of breast carcinoma was 99.2% (95% confidence interval, 95.6%-99.9%) in 173 palpable breast masses and 93.2% (95% confidence interval, 87.1%-97%) in 251 nonpalpable masses. In cancers diagnosed on the basis of immediate surgical excision as a result of ultrasonographically guided core biopsy that showed either questionable pathologic features or radiologic-pathologic discordance, the sensitivity of ultrasonographically guided core biopsy for the diagnosis of breast cancer was 99.2%. Conclusions. Ultrasonographically guided large-core needle biopsy is a sensitive percutaneous biopsy method for the diagnosis of breast cancer in palpable and nonpalpable breast masses.

Analysis of false-negative results after US-guided 14-gauge core needle breast biopsy

“…Percutaneous image-guided core needle biopsy (CNB) is accepted as a reliable alternative to surgical biopsy for obtaining a histological diagnosis of breast lesions [1][2][3][4][5][6][7][8][9][10][11][12][13]. The advantages of CNB over surgical biopsy include absence of scarring, little to no change in future mammograms, lower overall cost and faster patient recovery [2].…”

A comparison of mammography and ultrasonography in the evaluation of breast masses

“…They are also present in a rudimentary form in males. This tender, sensitive and delicate complex structure is constantly under the infl uence of hormones 1,2 . The breast develops from mammary ridges.…”

“…Of the various pathologies that affl ict the breast, cancers are most often encountered and are the most dreaded 1,2 . Despite the gloomy prognosis, increased morbidity and reduced survival time, it can be controlled if detection and diagnosis are made in the earliest stages i.e., in the pre-invasive and clinically nonpalpable stage.…”

The Role of Various Modalities in Breast Imaging

“…Fibroadenoma is the most common benign breast mass and invasive ductal carcinoma is the most common malignancy. Effi cient and accurate evaluation can maximize cancer detection and minimize unnecessary testing and procedures 4 .…”