Ultrasonography-guided 14-gauge core biopsy of the breast: results of 7 years of experience

Abstract

PurposeThis study assessed the outcomes of ultrasound (US)-guided core needle biopsies (CNBs) of breast lesions with at least 2 years of follow-up to determine the false-negative rate and to evaluate the diagnostic accuracy of CNB.MethodsWe retrospectively analyzed 13,254 consecutive US-guided 14-gauge CNBs for breast lesions. We excluded biopsies if non-malignant biopsy result was not confirmed by surgical excision or US-guided vacuum-assisted biopsy, or fewer than 2 years of follow-up data were available. A total of 4,186 biopsies were excluded, and 9,068 breast masses from 7,039 women were included. The pathologic findings from each CNB were assessed using the standard diagnostic reference, defined based on the results of surgical excision, vacuum-assisted biopsy, or at least 2 years of long-term imaging follow-up. The false-negative rate and underestimation rate were calculated.ResultsOf the 9,068 CNBs, benign pathology was found in 64.2%, high-risk results in 3.5%, and malignant results in 32.3%. Of the 5,821 benign CNBs, an additional malignancy was found at excision in 63 lesions, leading to a false-negative rate of 2.0% (63 of 3,067). The underestimation rate was 33.6% (111 of 330) for ductal carcinoma in situ and 24.5% (79 of 322) for high-risk results at surgical excision. Most false-negative diagnoses (84.1%, 53 of 63) were recognized through imaging-histology correlations, and immediate rebiopsies were performed. Ten malignancies (15.9%, 10 of 63) had delayed diagnoses and showed progression in follow-up US imaging.ConclusionUS-guided 14-gauge CNB provided optimal diagnostic information. Imaging-histology correlations and appropriate imaging follow-up should be performed to avoid delayed diagnoses.

Ultrasound Imaging Technologies for Breast Cancer Detection and Management: A Review

“…A prospective study of pathologically confirmed 110 lesions showed that DBCT provided high-quality images of the breast and could help radiologists to diagnose malignant breast lesions, as compared with ultrasound and digital mammography (He, et al 2016). In a recent study, DBCT was used to identify breast lesion and was compared with BI-RADS Mammography Atlas, the estimated overall sensitivity of the readers was 0.969, and the specificity was 0.529 (Jung, et al. 2017).…”

Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy

“…A later study in 2005 with long-term follow-up reported a false-negative rate of 3.7% for 14-gauge US-guided CNB, with three delayed diagnoses of cancer occurring at the site of prior CNB [ 5 ]. However, recent studies published in the last decade have reported slightly lower false-negative rates of US-guided CNB, ranging from 0.1% to 2.5%, with most cases identified because of discordance between imaging results and CNB histologic findings ( Table 1 ) [ 7 - 11 , 14 , 15 ]. The reported underestimation rate of high-risk lesions through US-guided CNB, a category primarily composed of atypical ductal hyperplasia (ADH) lesions in most studies, ranges from 24.5% to 65% [ 7 , 8 , 10 , 16 ].…”

Both a biopsy method and a therapeutic procedure in BI-RADS 4A and 4B lesions: Ultrasound-guided vacuumassisted breast biopsy

“…Percutaneous imaging-guided breast biopsies are easy, reliable and cost-effective that has taken the place of excisional biopsies and thus, the form of standard diagnostic procedure (1)(2)(3)(4). Percutaneous biopsies could be performed through stereotactic or ultrasound guidance.…”