Nuria Bermejo Espinosa MD, Presenter: Nothing to Disclose

Juan José Gómez, Abstract Co-Author: Nothing to Disclose

Jose Luis Del Cura MD, Abstract Co-Author: Nothing to Disclose

Rosa Zabala MD, Abstract Co-Author: Nothing to Disclose

Marta Bermejo, Abstract Co-Author: Nothing to Disclose

Domingo Grande, Abstract Co-Author: Nothing to Disclose

To assess the accuracy of sonographically guided core-needle-biopsy (SGCNB) and to study the causes of non-correlation between SGCNB and surgical diagnosis.

All SGCNB performed over a 7-year period in our institution were reviewed. The accuracy of the technique and the agreement with excision pathology were studied. Patients with benign biopsies were followed-up for at least two years.

2534 SGCNB were performed in 2173 patients. Cancer was final diagnosis in 996 lesions (39%). There were one false-positive and 20 false-negative biopsies. Sensitivity of SGCNB was 98% and specificity 99,9%. The false-positive was an invasive lobular carcinoma diagnosed as lobular carcinoma in situ on SGCNB. Nine of the false-negative cases were diagnosed on SGCNB as lesions that warranted surgical excision. A malignancy was discovered on surgery in 6% of the lesions diagnosed as papilloma on biopsy, in 19% of atypical ductal hyperplasias (ADH) and in 17% of radial scars. In 16% of proven phyllodes tumors, a fibroadenoma was diagnosed on biopsy. In 51 (5%) malignancies, a different type of carcinoma was diagnosed on biopsy and excision pathology. In 26 (2,6%), specific histology of the carcinoma was not determined on biopsy.

SGCNB has a very high accuracy and should be used in all breast abnormalities visible on ultrasound. However, sensibility in phyllodes tumors is low. In lesions diagnosed as ADH, radial scar or papilloma and those in which a phyllodes tumor is suspected, excision is warranted. In malignancies, agreement between specific histology on biopsy and surgery is excellent.

The SGCNB is an accurate, safe and reliable method for the assessment of sonographically detected breast abnormalities. It reduces the number of surgical breast biopsies, resulting more cost-effective

Espinosa, N, Gómez, J, Del Cura, J, Zabala, R, Bermejo, M, Grande, D, Sonographically-guided Core-needle Biopsy: Accuracy and Pitfalls.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005894.html