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Ultrasound-Guided Biopsy Offers High Sensitivity in Breast Cancer Diagnoses

October 13, 2009
Written by: , Filed in: Breast Imaging
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A recent study was conducted to evaluate biopsy results of sonographically guided 14-gauge core needle biopsies of breast masses.

The results have shown that ultrasound-guided 14-gauge core needle biopsy offers high sensitivity and low false-negative rates in evaluating breast masses.

Design/Participants
This was a retrospective review of 2420 breast masses in 2198 women.

Methodology
The study included 2420 palpable and nonpalpable breast masses that underwent ultrasound-guided 14-gauge core needle biopsies. Review of histopathologies, sensitivity, positive-predictive value, underestimation rate, false-negative rate, and 2-year follow-up results of biopsy-proven benign masses were performed.

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Related CME

Women's Imaging
University of California San Francisco, Department of Radiology

  The overall goal of this program is to provide current information on the relevant use of imaging and interventional techniques in women with breast and gynecologic pathology. Core concepts and future directions are addressed, including cancer screening, breast intervention, and current status of breast and gynecologic MRI. Up to 20.75 AMA PRA Category 1 Credit(s)™ are available.
Read more or order: Women's Imaging

Imaging Review: Body, Bone & Breast
University of California, San Francisco, Department of Radiology
  This program is designed for the radiologist in clinical practice, and is intended to provide an overview and update on clinically relevant topics in diagnostic imaging, as well as an up-to-date assessment of the clinical uses of modern imaging modalities such as CT, MR and ultrasound. 20 AMA PRA Category 1 Credit(s)™ are available.
  Read more or order: Imaging Review: Body, Bone & Breast

Results
1312 malignancies were diagnosed with a positive-predictive value of 52% and a sensitivity of 96%. About 1.3% of malignancies represented either lymphomas or metastasis to the breast. High-risk lesions consisted of 4% of biopsied masses.

At surgery, the underestimated rate of ductal carcinoma in situ was 29% and that of atypical ductal hyperplasia was 52%.

Repeat biopsy was performed in 116 lesions due to either discordant imaging-pathological correlation or interval lesion growth.

The false-negative rate was 2.4%.

Of 1071 benign lesions, 33% of lesions showed at least 2 years’ stability. The remaining benign lesions were surgically excised for various reasons.

Conclusions
Ultrasound-guided 14-gauge core needle biopsy offers high sensitivity and low false-negative rates in evaluating breast masses.

Reviewer’s Comments
Ultrasound-guided 14-gauge core needle biopsy is a safe and relatively fast method to obtain tissue sampling of breast masses. The results of this study show high sensitivity and very low false-negative rate of this technique. These rates are compatible to that of other percutaneous biopsy techniques and surgical excision in diagnosing malignancy.

The results of this study also emphasize the importance of imaging-pathological correlation immediately after core biopsy and close long-term imaging and clinical follow-up of benign lesions after core biopsies.

Author: Bokran Won, MD

Reference:
Youk JH, Kim EK, et al. Sonographically Guided 14-Gauge Core Needle Biopsy of Breast Masses: A Review of 2420 Cases With Long-Term Follow-Up. AJR; 2008; 190 (January): 202-207

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Related CME

Women's Imaging
University of California San Francisco, Department of Radiology

  The overall goal of this program is to provide current information on the relevant use of imaging and interventional techniques in women with breast and gynecologic pathology. Core concepts and future directions are addressed, including cancer screening, breast intervention, and current status of breast and gynecologic MRI. Up to 20.75 AMA PRA Category 1 Credit(s)™ are available.
Read more or order: Women's Imaging

Imaging Review: Body, Bone & Breast
University of California, San Francisco, Department of Radiology
  This program is designed for the radiologist in clinical practice, and is intended to provide an overview and update on clinically relevant topics in diagnostic imaging, as well as an up-to-date assessment of the clinical uses of modern imaging modalities such as CT, MR and ultrasound. 20 AMA PRA Category 1 Credit(s)™ are available.
  Read more or order: Imaging Review: Body, Bone & Breast
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