Abstract
BackgroundThe aims of this study were to determine the accuracy of concurrent core needle biopsy (CNB) and fine needle aspiration biopsy (FNAB) for breast lesions and to estimate the false-negative rate using the two methods combined.MethodsOver a seven-year period, 2053 patients with sonographically detectable breast lesions underwent concurrent ultrasound-guided CNB and FNAB. The sonographic and histopathological findings were classified into four categories: benign, indeterminate, suspicious, and malignant. The histopathological findings were compared with the definitive excision pathology results. Patients with benign core biopsies underwent a detailed review to determine the false-negative rate. The correlations between the ultrasonography, FNAB, and CNB were determined.ResultsEight hundred eighty patients were diagnosed with malignant disease, and of these, 23 (2.5%) diagnoses were found to be false-negative after core biopsy. After an intensive review of discordant FNAB results, the final false-negative rate was reduced to 1.1% (p-value = 0.025). The kappa coefficients for correlations between methods were 0.304 (p-value < 0.0001) for ultrasound and FNAB, 0.254 (p-value < 0.0001) for ultrasound and CNB, and 0.726 (p-value < 0.0001) for FNAB and CNB.ConclusionsConcurrent CNB and FNAB under ultrasound guidance can provide accurate preoperative diagnosis of breast lesions and provide important information for appropriate treatment. Identification of discordant results using careful radiological-histopathological correlation can reduce the false-negative rate.
Highlights
The aims of this study were to determine the accuracy of concurrent core needle biopsy (CNB) and fine needle aspiration biopsy (FNAB) for breast lesions and to estimate the false-negative rate using the two methods combined
Three main diagnostic procedures are used in the pathological examination of suspicious breast lesions: fine needle aspiration biopsy (FNAB), core needle biopsy (CNB), and surgical open biopsy
FNAB and CNB are minimally invasive procedures that can be performed on an outpatient basis[6,7]
Summary
The aims of this study were to determine the accuracy of concurrent core needle biopsy (CNB) and fine needle aspiration biopsy (FNAB) for breast lesions and to estimate the false-negative rate using the two methods combined. Breast cancer ranks fourth among the top 10 causes of death from cancer in women, and the death rate has increased from 5 to 12.8 per 100,000 population in the past two decades (data from the Bureau of Health Promotion, Department of Health, Taiwan; http://www.doh.gov.tw/statistic/data). Because of this increase in the death rate, screening has become more important in health care in Taiwan, and screening programs with mammography and ultrasound (US) are used routinely. FNAB and CNB are minimally invasive procedures that can be performed on an outpatient basis[6,7]
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