US-guided 14-gauge core-needle breast biopsy: Results of a validation study in 1352 cases Journal Article

Authors: Schueller, G.; Jaromi, S.; Ponhold, L.; Fuchsjaeger, M.; Memarsadeghi, M.; Rudas, M.; Weber, M.; Liberman, L.; Helbich, T. H.
Article Title: US-guided 14-gauge core-needle breast biopsy: Results of a validation study in 1352 cases
Abstract: Purpose: To retrospectively determine the false-negative rate and the underestimation rate of ultrasonography (US)-guided 14-gauge core-needle breast biopsy (CNB) in nonpalpable lesions, with validation at surgical excision histologic examination and with stability during clinical and imaging follow-up. Materials and Methods: Informed consent was waived by the institutional review board for this retrospective review of 1352 cases. In 1061 cases, patients underwent surgical excision of lesions visible at US subsequent to US-guided 14-gauge CNB. Follow-up of another 291 benign lesions at US-guided 14-gauge CNB histologic examination showed stability during clinical and imaging follow-up for at least 2 years. US and histologic findings were reviewed and compared for agreement. A false-negative finding was defined as pathologically proved cancer for which biopsy results were benign. The false-negative rate was defined as the proportion of all breast cancers with a diagnosis of benign disease at US-guided 14-gauge CNB. The underestimation rate was defined as an upgrade of a high-risk lesion at US-guided 14-gauge CNB to malignancy at surgery. Results: US 14-gauge CNB yielded 671 (63.2%) malignant, 86 (8.1%) high-risk, and 304 (28.7%) benign lesions. Each of the 291 benign lesions without surgery remained stable during follow-up. The agreement of US-guided 14-gauge CNB results, surgical excision findings, and follow-up results was 95.8% (κ = 0.93). False-negative findings were encountered in 11 (0.8%) of 1352 cases, and the false-negative rate was 1.6% (11 of 671 malignancies). All false-negative findings were prospectively identified owing to discordance between imaging results and US-guided 14-gauge CNB histologic findings. The underestimation rate was 31.4%. Conclusion: US-guided 14-gauge CNB is an alternative to surgical excision for assessing nonpalpable breast lesions. © RSNA, 2008.
Keywords: adolescent; adult; human tissue; aged; aged, 80 and over; middle aged; excision; retrospective studies; major clinical study; disease course; histopathology; follow up; methodology; diagnostic accuracy; laboratory diagnosis; breast cancer; echomammography; pathology; validation study; breast neoplasms; retrospective study; false negative result; diagnostic value; biopsy, needle; breast tumor; echography; needle biopsy; false negative reactions; statistics, nonparametric; breast biopsy; endoscopic echography; breast lesion; ultrasonography, interventional; nonparametric test; core needle breast biopsy
Journal Title: Radiology
Volume: 248
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2008-08-01
Start Page: 406
End Page: 413
Language: English
DOI: 10.1148/radiol.2482071994
PUBMED: 18641246
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 28" - "Export Date: 17 November 2011" - "CODEN: RADLA" - "Source: Scopus"
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MSK Authors
  1. Laura Liberman
    172 Liberman