Abstract
BackgroundTo assess the accuracy of ultrasound-guided 16G or 18G core needle biopsy (CNB) for ultrasound-visible breast lesions, and to analyze the effects of lesion features.MethodsBetween July 2005 and July 2012, 4,453 ultrasound-detected breast lesions underwent ultrasound-guided CNB and were retrospectively reviewed. Surgical excision was performed for 955 lesions (566 with 16G CNB and 389 with 18G CNB) which constitute the basis of the study. Histological findings were compared between the ultrasound-guided CNB and the surgical excision to determine sensitivity, false-negative rate, agreement rate, and underestimation rate, according to different lesion features.ResultsFinal pathological results were malignant in 84.1% (invasive carcinoma, ductal carcinoma in situ, lymphoma, and metastases), high-risk in 8.4% (atypical lesions, papillary lesions, and phyllodes tumors), and benign in 7.5%. False-negative rates were 1.4% for 16G and 18G CNB. Agreement rates between histological findings of CNB and surgery were 92.4% for 16G and 92.8% for 18G CNB. Overall underestimate rates (high-risk CNB becoming malignant on surgery and ductal carcinoma in situ becoming invasive carcinoma) were 47.4% for 16G and 48.9% for 18G CNB. Agreements were better for mass lesions (16G: 92.7%; 18G: 93.7%) than for non-mass lesions (16G, 85.7%; 18G, 78.3%) (P <0.01). For mass lesions with a diameter ≤10 mm, the agreement rates (16G, 83.3%; 18G, 86.7%) were lower (P <0.01).ConclusionsUltrasound-guided 16G and 18G CNB are accurate for evaluating ultrasound-visible breast mass lesions with a diameter >10 mm.
Highlights
To assess the accuracy of ultrasound-guided 16G or 18G core needle biopsy (CNB) for ultrasound-visible breast lesions, and to analyze the effects of lesion features
Stereotactic-guided percutaneous breast biopsy is mostly used for micro-calcifications, while ultrasound-guided biopsy is mostly used for masses and architectural distortions
Little information is currently available about needle size selection for ultrasound-guided biopsies of lesions with different imagery features, and most of this information comes from non-breast lesions [7], or from studies that used 14G needles only [8,9,10,11,12,13,14,15,16,17,18]
Summary
To assess the accuracy of ultrasound-guided 16G or 18G core needle biopsy (CNB) for ultrasound-visible breast lesions, and to analyze the effects of lesion features. Percutaneous ultrasound- and stereotactic-guided breast core needle biopsy (CNB) is widely used as a reliable alternative to surgical biopsy to obtain a histological diagnosis for imagery-visible suspicious breast lesions [1,2,3]. The accuracy of using 16G and 18G needles for ultrasound-guided CNB, especially for ultrasound-visible mass lesions, have not been fully assessed. One may raise the question about whether ultrasound-guided CNB with smaller needles, such as 16G and 18G, can have diagnostic value for ultrasound-visible lesions, and if there is any difference in the accuracy of biopsies of breast lesions with different imaging features
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