Ultrasound guided CNB is currently the most widely used image-guided biopsy procedure in the breast cancer diagnostic workup. Cone beam breast computed tomography (CBBCT) is a dedicated breast CT technology with 3D isotropic imaging of the breast. With dedicated accessories, CBBCT-guided CNB procedures can extract specimens with accuracy. However, whether the specimens acquired from different image-guided CNB procedures have the same immunohistochemical information remains unknown.The purpose of this study is to compare the consistency of immunohistochemical detection indexes and molecular subtypes in the specimens acquired with CBBCT-guided CNB, ultrasound-guided CNB , and surgical resection.

In this retrospective study, 73 patients who underwent image-guided CNB and the following surgical resection between July 2019 and November 2019 were included. All patients have the results of immunohistochemical detection indexes and molecular subtypes from both biopsy and surgical pathology analysis. Among the image-guided CNB procedures, 28 cases were CBBCT-guided and 45 cases were ultrasound-guided.The consistency of immunohistochemical detection indexes and molecular subtypes between the CNB specimens and surgical resection specimens was tested.

For CBBCT-guided CNB cases, the agreement rates of ER, PR, Her-2 and Ki-67 in the between CNB specimens and surgical specimens were 100%, 89.29%, 96.43% and 71.43%, and the corresponding Kappa values were 1, 0.7, 0.92, and 0.38 (all P values were <0.001). And the agreement rates of molecular subtypes between CBBCT-guided CNB specimens and surgical specimens was 85.71%, Kappa value was 0.75 (P <0.001). For ultrasound-guided CNB cases, the agreement rates of ER, PR,Her-2 and Ki-67 between CNB specimens and surgical specimens were 97.78%, 97.78%, 97.78% and 86.67%, and the corresponding Kappa values were 0.92, 0.94, 0.94, and 0.74 (all P values were <0.001). And the agreement rates of molecular subtypes between Ultrasound-guided CNB specimens and surgical specimens was 84.44%, the Kappa value was 0.74 (P <0.001).

Overall, the CBBCT-guided and ultrasound-guided CNB specimens are in close agreement with surgical specimens in immunohistochemical detection indexes and molecular subtypes.

Both the CBBCT-guided and ultrasound-guided CNB specimens can predict the immunohistochemical results and molecular subtypes of the lesion.