Abstract
Background: Core needle biopsy (CNB) under ultrasound guidance is an accepted standard of care for the diagnosis of breast lesions. It is safe, cost-effective and minimally invasive compared with surgical excision. Objective: The aim of this study was to evaluate the CNB’s results regarding the procedure, complications, histopathological findings and their correlation with the imaging data and surgical histopathological findings. Method: A cross-sectional prospective and descriptive study of a consecutive series of ultrasound-guided CNB of breast lesions in women conduced from January 2015 to December 2016 at the Sylvanus Olympio university hospital of Lomé, in Togo. Results: There were 72 CNB performed under ultrasound guidance in women; from which 54 were retained for the study. The mean age was 44.9 years ± 9.8. 11.1% had a family history of breast cancer. Lesions were most often palpable (90.7%). They were located in the left breast in 54.7%. Lesions were categorized probably malignant or malignant (Birads 4 and 5) in 70.4% and probably benign (Birads 3) in 29.6%. Their mean size was 24.8 mm ± 7.6 at ultrasound. There were no major complications during the procedure. One CNB (1.9%) considered inconclusive was repeated. Histologically, invasive ductal carcinoma (61.1%) was the most common lesion. Fifty-three women underwent surgical procedure and histopathological confirmation. Ultrasound-guided CNB had a sensitivity of 97.5%, specificity of 100%, positive predictive value of 100%, negative predictive value of 92.8%, and an overall diagnostic accuracy of 98.1%. Breast Imaging Reporting and Data System (Birads) categorization had a sensitivity of 94.8%, specificity of 100%, positive predictive value of 100%, negative predictive value of 87.4%, and diagnostic accuracy of 96.2%. Conclusion: Ultrasound guided CNB represent accurate methods for the characterization of breast lesions, with high values of diagnostic accuracy, sensitivity, specificity and negative predictive value. It does not involve a major complication, even in tropical environments.
Highlights
Breast cancer is the first cancer in women in the world; accounting for about 25% of female cancers with higher prevalence in developed countries and an average age of 50 - 70 years [1] [2]
Ultrasound-guided Core Needle Biopsy (CNB) had a sensitivity of 97.5%, specificity of 100%, positive predictive value of 100%, negative predictive value of 92.8%, and an overall diagnostic accuracy of 98.1%
Breast Imaging Reporting and Data System (Birads) categorization had a sensitivity of 94.8%, specificity of 100%, positive predictive value of 100%, negative predictive value of 87.4%, and diagnostic accuracy of 96.2%
Summary
Breast cancer is the first cancer in women in the world; accounting for about 25% of female cancers with higher prevalence in developed countries and an average age of 50 - 70 years [1] [2]. Core Needle Biopsy (CNB) under imaging guidance is an accepted standard of care for the diagnosis of breast lesions, those that are non-palpable [2]-[8] This procedure is safe, cost-effective and minimally invasive compared with surgical excision [5]. Core needle biopsy (CNB) under ultrasound guidance is an accepted standard of care for the diagnosis of breast lesions It is safe, cost-effective and minimally invasive compared with surgical excision. It does not involve a major complication, even in tropical environments
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