Evaluation of needle size for breast biopsy: comparison of 14-, 16-, and 18-gauge biopsy needles.

Helbich, Thomas H.; Rudas, M.; Haitel, Andrea; Kohlberger, Petra; Thurnher, Majda M.; Gnant, Michael; Wunderbaldinger, Patrick; Wolf, G; Mostbeck, G.

doi:10.2214/ajr.171.1.9648764

Cited by 65 publications

(42 citation statements)

References 28 publications

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“…However, the results of our study for diagnosing non-palpable solid breast lesions using US 18-gauge CNB show a diagnostic accuracy comparable to that noted in studies in which 14-gauge needles were used. A suggestion supported by our findings is that lesions in which mammography reveals the presence of microcalcifications frequently consist of friable and fatty tissue (12,21,22), both of which are believed to be responsible for incorrect diagnosis with smaller needles (12,21). We found that was much higher than in earlier reports, and that sensitivity was as high as when larger needles were used.…”

Section: Discussionsupporting

confidence: 81%

“…With the aim of reducing possible complications, including local hemorrhage, discomfort and tumor seeding along the needle track, an 18-gauge needle is used for US CNB. It has been reported that the risk of complications correlates with the size of needle used (9 11), and though a smaller (18-gauge) needle is in this respect advantageous, reports have claimed that for CNB diagnosis, a large needle (14-, or 16-gauge) is more accurate (12,13).…”

mentioning

confidence: 99%

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The Reliability of Ultrasound-guided Core Needle Biopsy in the Evaluation of Non-palpable Solid Breast Lesions Using 18-gauge Needles

Lim

Kim

Sneige

2003

J Korean Radiol Soc

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Purpose: Ultrasound-guided core needle biopsy (US CNB) is increasingly used in the histologic evaluation of non-palpable solid breast lesions. We retrospectively investigated the diagnostic accuracy of this technique, using an 18-gauge needle in 422 nonpalpable breast lesions. Materials and Methods: 583 female patients with an average age of 56 (range, 22 90) years underwent 590 US CNBs. Between January 1994 and December 1999, using 18-gauge needles, an average of four cores per lesion was obtained. Three hundred and eighty-five lesions were subsequently surgically excised; for 14 of these, the pathologic diagnosis was breast carcinoma metastasis, while 23 with benign diagnoses were clinically followed up for 2.5 years and were considered for analysis. Results: Of the 422 lesions, 340 (80.6%) were malignant [308 invasive, 24 ductal carcinoma in situ (DCIS), 7 DCIS with undetermined invasion and 1 DCIS vs. lobular carcinoma in situ], 67 (15.9%) were benign [30 fibroadenoma (FA) and 37 other diagnoses], and five (1.2%) were fibroepithelial lesions. The remaining ten samples (2.4%) included six cases of atypical ductal hyperplasia (ADH), two of atypical hyperplasia (AH), and two of lobular neoplasia. The sensitivity, specificity, positive predictive value, and negative predictive value of CNBs were 99%, 100%, 100%, and 96%, respectively. Two cases of invasive carcinoma were missed at CNB; there was no false-positive diagnosis. Five of six ADHs and one of two AHs were found to be carcinomas (3 DCIS and 3 infiltrating duct carcinomas). Sixteen of 24 (66.7%) cases of DCIS were found at excision to be invasive carcinomas. Of 31 FAs, two (6.5%) were found to be low-grade phyllodes tumor (PT). The five fibroepithelial lesions were shown at excision to be either PT (n=4) or FA (n=1). Conclusion: US CNB using an 18-gauge needle is a safe and reliable means of diagnosing breast carcinoma. Because of the high prevalence of ductal carcinoma in these lesions; findings of ADH/AH at US CNB indicate that surgical excision is needed. In order to rule out low-grade PT, a diagnosis of FA at CNB requires close follow-up.

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 99%

The Reliability of Ultrasound-guided Core Needle Biopsy in the Evaluation of Non-palpable Solid Breast Lesions Using 18-gauge Needles

Lim

Kim

Sneige

2003

J Korean Radiol Soc

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“…An 18-G needle is the most common needle calibre used to obtain prostatic tissue, although this convention is derived from the transrectal approach, which requires this needle size. As reported in previous breast cancer trials, tissue harvested using smaller needles is frequently friable and tends to fragment more often than tissue harvested using larger ones [5]. The use of a larger calibre needle certainly increases the amount of tissue harvested during biopsy and could potentially improve histological sampling, thereby enhancing the accuracy of prostate cancer diagnosis.…”

Section: Introductionmentioning

confidence: 85%

“…In one study, the use of an 18-G needle provided a 6.4-mm 2 specimen, compared with the 9.6-mm 2 (mean values) sample obtained using a 16-G needle [5]. As a result, the quality of the tissue samples obtained during biopsy was significantly superior when a 16-G needle was used.…”

Section: Discussionmentioning

confidence: 99%

“…The use of a larger calibre needle certainly increases the amount of tissue harvested during biopsy and could potentially improve histological sampling, thereby enhancing the accuracy of prostate cancer diagnosis. In a previous study, 14-G needles were compared with 16-G needles in patients undergoing breast biopsies, and the results indicated that patients who underwent breast biopsy using the larger calibre needle did not experience significantly worse side effects than patients whose biopsy was performed using the smaller needle [5]. On the basis of these findings, we sought to examine whether or not the same findings would hold true in prostate biopsies.…”

Section: Introductionmentioning

confidence: 98%

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Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial

Saredi¹,

Mc²,

Fidanza³

et al. 2009

Asian J Androl

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Transperineal prostate biopsy is a procedure that can be used to obtain histological samples from the prostate. To improve both the quality of the biopsy core samples and prostate cancer detection, we are currently performing a prospective, randomized trial comparing prostate biopsy samples obtained using an 18 G-needle to those obtained using a 16 G needle. The aim of this preliminary study was to evaluate pain and complication rates in both groups in order to assess whether performing a prostate biopsy with a larger calibre needle is a feasible procedure. One hundred and eighty-seven patients undergoing transperineal prostate biopsy were prospectively evaluated and divided into two groups. The first group (94 patients, Group A) received a transperineal prostate biopsy using a 16 G-needle and the second group (93 patients, Group B) underwent transperineal prostate biopsy with an 18 G-needle. Anaesthesia was obtained with a single perineal injection at the prostatic apex in all subjects. A visual analogue scale (VAS) and facial expression scale (FES) were used to assess pain during multiple steps of the procedure in each group. A detailed questionnaire was used to obtain information about drug use because it could potentially influence the pain and complications that patients experienced. Two weeks after the procedure, early and late complications were evaluated. Statistical analysis was carried out using non-parametric tests. Prostate Specific Antigen (PSA) and drug use were similar at baseline between the two groups. Pain during prostate biopsy, which was measured with both the VAS and FES instruments, did not differ significantly between the 18-and 16 G-needle groups, and no significant differences were found in early or late complication rates between the groups. Transperineal prostate biopsy with a 16 G-needle is a feasible procedure in terms of pain and complication rates. Further studies with larger patient populations are required to assess whether or not this procedure can improve prostate cancer detection rates.

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A comparison of aspiration cytology and core needle biopsy in the evaluation of breast lesions

Westenend

Sever

Volder

et al. 2001

Cancer

116

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BACKGROUND Several arguments are used for choosing either fine‐needle aspiration cytology (FNAC) or core needle biopsy (CNB) in the evaluation of breast lesions. Comparison of published data on both methods is complicated by differences in study design, calculations, and operator experience. The objective of this study was to make a direct comparison of both methods. METHODS In 286 breast lesions (cysts and microcalcifications without a soft tissue mass excluded), both ultrasound‐guided FNAC and CNB were performed in the same session by the same operator. Histologic follow‐up was collected, and for those lesions that were not excised the results of the most recent mammography was used. A combination of the findings of both FNAC and CNB were evaluated. RESULTS Core needle biopsy and FNAC do equally well for sensitivity (88% vs. 92%), positive predictive value for malignancy (99% vs. 100%), and inadequate rate (7% vs. 7%). However, statistical differences are found for the specificity (CNB, 90%; FNAC, 82%). In addition, differences are found in the positive predictive value of both suspicious (CNB, 100%; FNAC, 78%) and atypia (CNB, 80%; FNAC, 18%) and for the suspicious rate (CNB, 5%; FNAC, 13%) reflecting difficulties in interpreting some FNACs. Combining the findings of both FNAC and CNB results in an increase in absolute sensitivity, a decrease in the positive predictive value of atypia compared with FNAC and CNB per se, and a decrease in the inadequate rate for cancers. CONCLUSIONS For the lesions selected in this study, FNAC and CNB are comparable for most parameters, but CNB has a higher specificity and lower suspicious rate. Combining results of FNAC and CNB leads to an increase in absolute sensitivity without affecting specificity and a decrease in the inadequate rate for cancers. Cancer (Cancer Cytopathol) 2001;93:146–150. © 2001 American Cancer Society.

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Evaluation of needle size for breast biopsy: comparison of 14-, 16-, and 18-gauge biopsy needles.

Cited by 65 publications

References 28 publications

The Reliability of Ultrasound-guided Core Needle Biopsy in the Evaluation of Non-palpable Solid Breast Lesions Using 18-gauge Needles

The Reliability of Ultrasound-guided Core Needle Biopsy in the Evaluation of Non-palpable Solid Breast Lesions Using 18-gauge Needles

Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial

A comparison of aspiration cytology and core needle biopsy in the evaluation of breast lesions

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