The Utility Of Sonographically Guided Core Needle Biopsy In Diagnosis Of Breast Masses

ObjectiveTo evaluate the accuracy and influencing factors of ultrasound-guided core needle biopsy (CNB) in the diagnosis of breast lesions that can be touched, mammography detected but nonpalpable or ultrasound examination revealed.MethodsA total of 319 lesions from 289 women who had undergone sonographically guided core needle biopsy of breast lesion was collected in this study.We collected 319 lesions percutaneous CNB histopathologic examination results and open surgical biopsy outcome or follow-up results of long-term to assess agreement rate, high-risk (HR) underestimate rate, ductal carcinoma in situ (DCIS) underestimate rate, and false-negative rate.ResultsThe pathologic results for the core needle biopsies were malignant in 52% (166/319), high-risk(HR) in 4%(13/319), and benign in 44%(140/319). The agreement rate was 96%(305of 319), The underestimate rate was 29%(5 of17) for DCIS and 31%(4 of 13) for high-risk (50% for 4 atypical ductal hyperplasia (ADH), 22% for 9 non-ADH).Of 140 benign lesions, malignancy was found at rebiopsy in 5 lesions (3 immediate and 2 delayed false-negative diagnosis), and the false-negative rate was 2.9%(5 of 175). The frequency of malignancy in lesions that had rebiopsy because of suspicious imaging findings (19.0%, four of 21) was significantly higher than that because of suspicious physical findings or request by patient or physician (1.1%, one of 93). Comparison between the two was statistically significant (p< 0.01)。Different characteristics of the lesions between the false negative rate is not significantly different (P>0.05)Conclusions1,Ultrasound-guided CNB with histopathological assessment is an accurate method of assessing breast lesions。2,The radiologist performing this procedure need to be aware of the possibility of a false-negative diagnosis. For lowering them, the imaging-histologic correlation is of critical importance in percutaneous imaging-guided breast biopsy, careful imaging-histologic correlation allows the radiologist to identify discordant lesions prospectively and recommend prompt rebiopsy, avoiding diagnostic delay. In addition, ultrasound image-guided CNB diagnosis was benign breast lesions is necessary to conduct follow-up.3,To reduce the underestimation rate of histological lesions, diagnosis of ultrasound image-guided percutaneous core needle histopathologic was high-risk lesions in patients in need of surgical excision biopsy.