- Volume 15 Issue 7
DOI QR Code
US-guided 14G Core Needle Biopsy: Comparison Between Underestimated and Correctly Diagnosed Breast Cancers
- Kim, Hana (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
- Youk, Ji Hyun (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
- Kim, Jeong-Ah (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
- Gweon, Hye Mi (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
- Jung, Woo-Hee (Department of Diagnostic Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
- Son, Eun Ju (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine)
- Published : 2014.04.01
Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoing ultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated and accurately diagnosed groups. Materials and Methods: Of 1,898 cases of US-guided 14G CNB in our institute, 233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductal carcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in 14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11 cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctly diagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breast cancers were compared. Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Among underestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB proven ADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results were IDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADS category, margin of mass on mammography and US and orientation of lesion on US revealed statistically significant differences. Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Between underestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography and margin and orientation of the lesions on US were different.
- Ko E, Han W, Lee JW, et al (2008). Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy. Breast Cancer Res Treat, 112, 189-95. https://doi.org/10.1007/s10549-007-9824-0
- Crystal P, Koretz M, Shcharynsky S, Makarov V, Strano S (2005). Accuracy of sonographically guided 14-gauge core-needle biopsy: results of 715 consecutive breast biopsies with at least two-year follow-up of benign lesions. J Clin Ultrasound , 33, 47-52. https://doi.org/10.1002/jcu.20089
- Hsu HH, Yu JC, Hsu GC, et al (2012). Atypical ductal hyperplasia of the breast diagnosed by ultrasonographically guided core needle biopsy. Ultraschall Med, 33, 447-54.
- Jang M, Cho N, Moon WK, et al (2008). Underestimation of atypical ductal hyperplasia at sonographically guided core biopsy of the breast. AJR Am J Roentgenol, 191, 1347-51. https://doi.org/10.2214/AJR.07.3643
- Lee KE, Kim HH, Shin HJ, Cha JH (2013). Stereotactic biopsy of the breast using a decubitus table: comparison of histologic underestimation rates between 11-and 8-gauge vacuum-assisted breast biopsy. Springerplus, 22, 551.
- Ozkan-Gurdal S, Cabioglu N, Ozcinar B, et al (2014). Factors predicting microinvasion in ductal carcinoma in situ. Asian Pac J Cancer Prev, 15, 55-60. https://doi.org/10.7314/APJCP.2014.15.1.55
- Page DL, Jensen RA (1994). Evaluation and management of high risk and premalignant lesions of the breast. World J Surg, 18, 32-4. https://doi.org/10.1007/BF00348189
- Page DL, Rogers LW (1992). Combined histologic and cytologic criteria for the diagnosis of mammary atypical ductal hyperplasia. Hum Pathol, 23, 1095-7. https://doi.org/10.1016/0046-8177(92)90026-Y
- Philpotts LE, Lee CH, Horvath LJ, et al (2000). Underestimation of breast cancer with 11-gauge vacuum suction biopsy. lAm J Roentgenol, 175, 1047-50. https://doi.org/10.2214/ajr.175.4.1751047
- Wiratkapun C, Treesit T, Wibulpolprasert B, Lertsithichai P (2012). Diagnostic accuracy ultrasonography-guided core needle biopsy for breast lesions. Singapore Med J, 53, 40-5.
- Sauer G, Deissler H, Strunz K, et al (2005). Ultrasound guided large-core needle biopsies of breast lesions: analysis of 962 cases to determine the number of samples for reliable tumour classification. Br J Cancer, 92, 231-5. https://doi.org/10.1038/sj.bjc.6602303
- Suh YJ, Kim MJ, Kim EK, et al (2012). Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 8-or 11-gauge vacuum-assisted biopsy. Br J Radiol, 85, 349-56. https://doi.org/10.1259/bjr/30974918
- Teng-Swan Ho J, Tan PH, Hee SW, Su-Lin Wong J (2008). Underestimation of malignancy of atypical ductal hyperplasia diagnosed on 11-gauge stereotactically guided mammotome breast biopsy: an Asian breast screen experience. Breast, 17, 401-6. https://doi.org/10.1016/j.breast.2008.02.007
- Youk JH, Kim EK, Kim MJ (2009). Atypical ductal hyperplasia diagnosed at sonographically guided 14-gauge core needle biopsy of breast mass. Am J Roentgenol, 192, 1135-41. https://doi.org/10.2214/AJR.08.1144
- American College of Radiology (2003). Breast imaging reporting and data system (BI-RADS), 4th ed. Reston, VA: American College of Radiology.
- Cassano E, Urban LABD, Pizzamiglio M, et al (2007). Ultrasound-guided vacuumassisted core breast biopsy: experience with 406 cases. Breast Cancer Res Treat, 102, 103-10. https://doi.org/10.1007/s10549-006-9305-x
- Chae BJ, Lee A, Song BJ, Jung SS (2009). Predictive factors for breast cancer in patients diagnosed atypical ductal hyperplasia at core needle biopsy. World J Surg Oncol, 7, 77-82. https://doi.org/10.1186/1477-7819-7-77
- Ultrasonography-guided 14-gauge core biopsy of the breast: results of 7 years of experience vol.37, pp.1, 2018, https://doi.org/10.14366/usg.17028