Breast ; Biopsy ; Ultrasound guidance ; Breast cancer diagnosis
Abstract
Purpose: The objective of our study was to determine the diagnostic accuracy, underestimation rate and false negative rate of sonographically guided core needle biopsy for breast lesions.
Materials and Methods: In this retrospective study, we included a total of 894 lesions from 682 patients who had undergone sonographically guided 14-gauge core needle biopsies between March 2013 and December 2013. The sonographic category of breast lesions and the pathologic results of core needle biopsies were reviewed and correlated with that of surgery or vacuum assisted biopsy, or long term (>1yr) imaging follow-up. Through this, the positive predictive value for each sonographic category, sensitivity, underestimation rate and false negative rate of core needle biopsy were evaluated.
Results: A total of 894 cases, the pathologic results for the core needle biopsy were benign in 497, high-risk in 134, ductal carcinoma in situ in 44, invasive cancer in 216, other malignant tumor in 3. The positive predictive values for each sonographic category were as follows: 0.0% in category 2; 4.0% in category 3; 13.4% in category 4a; 48.9% in category 4b; 87.9% in category 4c and 96.3% in category 5. The sensitivity of core needle biopsy was 93.3% (263 of 282). The underestimation rate was 11.9% for high-risk lesion(21.1% of atypical ductal hyperplasia, 10.4% for non-atypical ductal hyperplasia) and 36.4% (16 of 44) for ductal carcinoma in situ. Of 497 benign lesions, 3 lesions were confirmed as malignancy, and the false negative rate was 0.6%.
Conclusion: Sonographically guided core needle biopsy for 10 months of 2013 year in our hospital was accurate diagnostic tool for evaluating breast lesion.