The accuracy of ultrasound guided 14–gauge core needle breast biopsy: Correlation with surgical excision or long term follow–up

Objective: To determine the diagnostic accuracy of ultrasound-guided 14-gauge core-needle\udbreast biopsy (CNB) correlation with surgical excision or long term follow-up. Methods:\udOne hundred and fifteen breast lesions which had undergone ultrasound-guided 14-gauge\udcore-needle breast biopsy from May 2003 to Aug 2010 in the Breast Diagnostic Center, King\udChulalongkorn Memorial Hospital were included in this study. Clinical history, palpability of the\udlesion, site of the lesion, the prebiopsy lesion size, ultrasound characteristic, level of suspicion\udaccording to the BIRADS classification, number of samples taken and pathologic results of CNB\udwere reviewed and correlated with pathologic results of subsequent open surgery. For benign\udlesions without surgery, we correlated the result of CNB with stability of the lesion at or more than\udtwo-year interval follow-up. The accuracy rate, sensitivity, specificity, false positive rate, false\udnegative rate, positive predictive value and negative predictive value were accessed. The falsenegative diagnoses of core needle biopsy were reviewed in detail. Procedural complications were\udalso observed. Results: Among 115 lesions, 114 lesions were in female and 1 lesion was in male\udwith their mean age of 50.87 years old (ranging from 27-72), 91 lesions were palpable (79.13%), 24\udwere non-palpable (20.87%). The prebiopsy size was 3.2 cm in diameter ranging from 0.5-20.0\udcm. The pathologic results for the CNB were malignancy in 77.39% (89 lesions), high-risk in 0.87%\ud(1 lesion) and benign in 21.17% (25 lesions). Five patients were negative for malignancy by core\udneedle biopsy but positive for malignancy by surgical procedure. The sensitivity was 94.68%. The\udspecificity was 100%. The false negative rate was 5.3%. The positive predictive value was 100%. The\udnegative predictive value was 80.76%. The accuracy was 95.65%. There was no false positive case.\udConclusions: Core needle biopsy under ultrasound guidance is a minimally invasive diagnostic\udtool and gives a high accuracy rate for evaluating breast lesions. This procedure reduces the\udsurgical cases of benign breast disease. However, correlation between imaging and pathology is\udimportant for appropriate management of false negative cases