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Examining the sensitivity of ultrasound‐guided large core biopsy for invasive breast carcinoma in a population screening programme
Author(s) -
Rouse Hannah C.,
Ussher Simon,
Kavanagh Anne M.,
Cawson Jennifer N.
Publication year - 2013
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12050
Subject(s) - medicine , false positive paradox , biopsy , radiology , histology , population , ultrasound , carcinoma , false negative reactions , positive predicative value , breast cancer , cancer , pathology , predictive value , environmental health , machine learning , computer science
Abstract Introduction To evaluate the sensitivity of ultrasound‐guided core‐needle biopsy ( UCB ) in invasive breast carcinoma and to establish causes of false‐negative biopsy in a population screening programme. Method We identified 571 consecutive women diagnosed with surgically proven invasive breast cancer. Histology from 14‐gauge UCB was compared with surgical histology to identify true‐positive and false‐negative ultrasound core biopsies. True‐positive and false‐negative groups were compared for tumour size and histology. On blinded review of UCB images and pathology reports from false negative ( n = 20) and a random sample of true‐positive cases ( n = 80), we compared core sample number and needle visualisation in the lesion. Results Of 571 carcinomas sampled with UCB , 551 (96.5%) were true positive and 20 (3.5%) were false negative. The mean core number was 2.0 (range 1–3) for false negatives and 2.25 (range 1–4) for true positives ( P = 0.27). Mean tumour sizes were 13.3 and 16.2 mm for the false‐negative and true‐positive groups, respectively ( P = 0.25). Tubular carcinomas represented 30% (6/20) of false‐negative cases compared with 5.1% (28/551) of the true‐positive cases ( P < 0.001). On blinded review, needle visualisation within the lesion was demonstrated in 47.4% (9/19) of false‐negative cases and 76.3% (61/80) of true‐positive cases ( P = 0.02). Conclusion We demonstrated a sensitivity of 96.5% with a mean of 2.21 cores. False‐negative results were more likely in the absence of post‐fire needle position verification and with tubular carcinomas. Neither tumour size nor core number predicted diagnostic accuracy.