Breast Core-Needle Biopsy in a Large Tertiary Oncologic Centre—1-Year Experience after the Introduction of the Method

Abstract

Ultrasound (US)-guided core-needle biopsy (CNB) is currently the procedure of choice for work-up of suspicious breast lesion. It is mainly used for evaluation of suspicious breast lesions categorized as BI-RADS 4 and 5 (Breast Imaging-Reporting and Data System). The conducted study included 56 female patients with detected suspicious breast leasions, and they underwent US-guided CNB during 1-year period with the aim to investigate the value of US-guided CNB of the breast in a tertiary-level large-volume oncological centre setting with respect of indications, technical adequacy and safety. 2 patients who entered the study were previously diagnosed as BIRADS 2, 3 patients as BIRADS 3, 18 patients as BIRADS 4 and 33 patients as BIRADS 5. In 14 patients with BC (breast cancer), both FNA (fine-needle aspiration) and CNB were performed, and the malignancy was accurately diagnosed by cytology in 9 patients, confirmed by subsequent CNB in all of them. ADH (atypical ductal hyperplasia) was initialy diagnosed by FNA in 5 patients, and in 2 of them, BC was initialy missed by FNA, but deteced by CNB. As it is known, the cytology has lower sensitivity for detection of BC than hystology, with false-negative rate ranging from 2.5% to 17.9%. In our material, 18.7% of carcinomas were initialy left undetected by FNAC, and subsequently confirmed by CNB. All confirmed carcinomas were correctly suspected on imaging, and categorized as BI-RADS 4 or 5, while all BI-RADS 2 and 3 findings were confirmed as benign on hystology. False-positive rate of imaging was 8%. An average number of 4 tissue cores (range: 2 - 7) was taken in our experience if good quality of the first 3 core was achieved, and there was no consistent reason to proceed with sampling.