Accuracy of ultrasound-guided, large-core needle breast biopsy

Abstract

Ultrasound-guided, large-core needle biopsy (US-LCNB) of suspicious breast lesions is acknowledged as less invasive and less expensive and less time consuming than surgical biopsy, and provides a histologic diagnosis with a comparable high degree. US-LCNB has been proven to help reduce the number of unnecessary surgeries for benign disease. Its limitations, however, are false-negative results and underestimation of disease. Thus, the demand for breast teams is to carefully adhere to the principles of triple assessment and imaging-histologic correlation, and follow-up of lesions with a specific benign histology after biopsy. Also, the acceptance of guidelines and rigorous quality controls help to reliably minimize the delay in the diagnosis of breast cancer in patients with false-negative biopsies. This paper aims to summarize the equipment and methods as well as the benefits and limitations of US-LCNB. Also, guidelines of quality assessment are suggested. Finally, recent developments which may help to overcome the limitations of US-LCNB will be discussed, i.e., directional vacuum-assisted biopsy (VAB), three-dimensional (3D) US-guided biopsy, as well as the use of tissue harmonic imaging (THI) and compound imaging (CI) during biopsy.

Magnetic Resonance Imaging Guided Vacuum Assisted and Core Needle Biopsies

“…If the result is malignant then therapeutic procedures may be directly applied. The rate of detecting malignancy after surgical excision of BI-RADS 4-5 lesions varies between 15-40%, while this rate varies between 70-80% in surgical excision after detection of malignancy by radiologic sampling methods (12,13). Meta-analyses including many studies state that radiologic biopsy methods should be preferred to surgical biopsy, if it can be performed (14,15).…”

Factors associated with the misdiagnosis of sentinel lymph nodes using touch imprint cytology for early stage breast cancer

“…Ultrasoundguided core needle biopsy is considered to be a reliable non-invasive alternative to surgical biopsy for obtaining a histopathological diagnosis with considerable sensitivity and specificity. However, its limitations include relatively high false-negative results (range 0.9-9.0%) and underestimation of disease with a wide range (17), suggesting that it is necessary to perform intraoperative assessment for patients with DCIS diagnosed by core needle biopsy who may need SLNB. Studies have indicated that lobular histology may be more difficult to interpret using touch imprint cytology, leading to a higher false-negative rate (18).…”

Meme Biyopsisi: Hasta ve Yöntem Seçimi; Hangi Lezyonda Ne Yapalım?

“…Görüntüleme bulguları değerlendirilerek yapılan örneklemelerde malignite tespit oranı %20 düzeylerindedir. BI-RADS 4-5 lezyonda malignite teşhis oranları direk eksizyon yapı-lan örneklemelerde %15-40 arasında değişir-ken, görüntüleme eşliğinde yapılan biyopsiler sonrasında %70-80 arasındadır [3,4]. Görün- tüleme eşliğinde biyopside hedef, konservatif tanı oranını en üst düzeye çıkarmak ve tekrar iğne biyopsi prosedürleri sayısını en aza indirmek için hatalı örnekleme sayısını %5'in altına düşürmektir [4].…”