IJCM  Vol.7 No.10 , October 2016
Breast Core-Needle Biopsy in a Large Tertiary Oncologic Centre—1-Year Experience after the Introduction of the Method
Abstract: Ultrasound (US)-guided core-needle biopsy (CNB) is currently the procedure of choice for work-up of suspicious breast lesion. It is mainly used for evaluation of suspicious breast lesions categorized as BI-RADS 4 and 5 (Breast Imaging-Reporting and Data System). The conducted study included 56 female patients with detected suspicious breast leasions, and they underwent US-guided CNB during 1-year period with the aim to investigate the value of US-guided CNB of the breast in a tertiary-level large-volume oncological centre setting with respect of indications, technical adequacy and safety. 2 patients who entered the study were previously diagnosed as BIRADS 2, 3 patients as BIRADS 3, 18 patients as BIRADS 4 and 33 patients as BIRADS 5. In 14 patients with BC (breast cancer), both FNA (fine-needle aspiration) and CNB were performed, and the malignancy was accurately diagnosed by cytology in 9 patients, confirmed by subsequent CNB in all of them. ADH (atypical ductal hyperplasia) was initialy diagnosed by FNA in 5 patients, and in 2 of them, BC was initialy missed by FNA, but deteced by CNB. As it is known, the cytology has lower sensitivity for detection of BC than hystology, with false-negative rate ranging from 2.5% to 17.9%. In our material, 18.7% of carcinomas were initialy left undetected by FNAC, and subsequently confirmed by CNB. All confirmed carcinomas were correctly suspected on imaging, and categorized as BI-RADS 4 or 5, while all BI-RADS 2 and 3 findings were confirmed as benign on hystology. False-positive rate of imaging was 8%. An average number of 4 tissue cores (range: 2 - 7) was taken in our experience if good quality of the first 3 core was achieved, and there was no consistent reason to proceed with sampling.
Cite this paper: Brnić, Z. , Marinkić, M. , Schmidt, S. , Pedišić, I. and Bolanča-Čulo, K. (2016) Breast Core-Needle Biopsy in a Large Tertiary Oncologic Centre—1-Year Experience after the Introduction of the Method. International Journal of Clinical Medicine, 7, 690-697. doi: 10.4236/ijcm.2016.710075.

[1]   Leconte, I., Feger, C., Galant, C., Berliere, M., Berg, B.V., D’Hoore, W., et al. (2003) Mammography and Subsequent Whole-Breast Sonography of Nonpalpable Breast Cancers: The Importance of Radiologic Breast Density. American Journal of Roentgenology, 180, 1675-1679.

[2]   Kolib, T.M., Lichy, J. and Newhouse, J.H. (2002) Comparison of the Performance of Screening Mammography, Physical Examination, and Breast US and Evaluation of Factors That Influence Them: An Analysis of 27,825 Patient Evaluations. Radiology, 225, 165-175.

[3]   Parker, S.H., Jobe, W.E., Dennis, M.A., Stavros, A.T., Johnson, K.K., Yakes, W.F., et al. (1993) US-Guided Automated Large-Core Breast Biopsy. Radiology, 187, 507-511.

[4]   Sickles, E.A., D’Orsi, C.J., Bassett, L.W., et al. (2013) ACR BI-RADS Mammography. In: ACR BI-RADS Atlas, Breast Imaging Reporting and Data System, 5th Edition, American College of Radiology, Reston, VA, 134-136.

[5]   Mendelson, E.B., Böhm-Vélez, M., Berg, W.A., et al. (2013) ACR BI-RADS Ultrasound. In: ACR BI-RADS Atlas, Breast Imaging Reporting and Data System, 5th Edition, American College of Radiology, Reston, VA, 128-130.

[6]   Pijnappel, R.M., van den Donk, M., Holland, R., Mali, W.P., Peterse, J.L., Hendriks, J.H., et al. (2004) Diagnostic Accuracy for Different Strategies of Image-Guided Breast Intervention in Cases of Nonpalpable Breast Lesions. British Journal of Cancer, 90, 595-600.

[7]   Parker, S.H., Burbank, F., Jackman, R.J., Aucreman, C.J., Cardenosa, G., Cink, T.M., et al. (2004) Percutaneous Large-Core Breast Biopsy: A Multi-Institutional Study. Radiology, 193, 359-364.

[8]   Vargas, H.I., Vargas, M.P., Gonzalez, K.D., Venegas, R., Canet, M., Burla, M., et al. (2004) Diagnosis of Palpable Breast Masses: Ultrasound-Guided Large Core Biopsy in a Multi-disciplinary Setting. Annals of Surgery, 70, 867-871.

[9]   Liberman, L. (2000) Percutaneous Imaging-Guided Core Breast Biopsy: State of the Art at the Milennium. American Journal of Roentgenology, 174, 1191-1199.

[10]   Liberman, L. (2002) Percutaneous Image-Guided Core Breast Biopsy. Radiologic Clinics of North America, 40, 483-500.

[11]   Liberman, L., Feng, T.L., Dershaw, D.D., Morris, E.A. and Abramson, A.F. (1998) US-Guided Core Breast Biopsy: Use and Cost-Effectiveness. Radiology, 208, 717-723.

[12]   Dillon, M.F., Hill, A.D., Quinn, C.M, O’Dohrety, A. and McDermott, E.W. (2005) The Accuracy of Ultrasound, Stereotactic, and Clinical Core Biopsiesinth Diagnosis of Breast Cancer with an Analysis of False-Negative Cases. Annals of Surgery, 242, 701-707.

[13]   Burkhardt, J.H. and Sunshine, J.H. (1992) Core-Needle and Surgical Breast Biopsy: Comparison of Three Methods of Assessing Cost. Radiology, 212, 181-188.

[14]   Prutki, M., Stern-Padovan, R., Jakic-Razumovic, J., Potocki, K., Badovinac-Crnjevic, T. and Golubic, A.T. (2012) Ultrasound-Guided Breast Biopsy—A Retrospective Study and Literature Review. Lijec Vjesn, 134, 270-275.

[15]   Willems, S.M., van Deurzen, C.H.M. and van Diest, P.J. (2012) Diagnosis of Breast Lesions: Fine-Needle Aspiration Cytology or Core Needle Biopsy? Journal of Clinical Pathology, 65, 287-292.

[16]   Kocjan, G., Bourgain, C., Fassina, A., Hagmar, B., Herbert, A. and Kapila, K. (2008) The Role of Breast FNAC in Diagnosis and Clinical Management: A Survey of Current Practice. Cytopathology, 19, 271-278.

[17]   Rakha, E.A. and Ellis, I.O. (2007) An Overview of Assessment of Prognostic and Predictive Factors in Breast Cancer Needle Core Biopsy Specimens. Journal of Clinical Pathology, 60, 1300-1306.

[18]   Chaiwun, B. and Thorner, P. (2007) Fine Needle Aspiration for Evaluation of Breast Masses. Curr Opin Obstet Gynecol, 19, 48-55.

[19]   Youk, J.H., Kim, E.K., Kim, M.J. and Oh, K.K. (2007) Missed Breast Cancers at US-Guided Core Needle Biopsy: How to Reduce Them. Radiographics, 27, 79-94.

[20]   Dahmer Rocha, R., Reis Pinto, R., Paes Barreto, D., Tavares, A. and Aires Goncavles, C.S. (2013) Step-by-Step of Ultrasound Guided Core-Needle Biopsy of the Breast: Review and Technique. Radiologia Brasileira, 46, 234-241.

[21]   Zhang, Y.J., Wei, L., Zheng, Y.Q. and Li, X.R. (2013) Status Quo and Development Trend of Breast Biopsy Technology. Gland Surgery, 2, 15-24.

[22]   Tamaki, K., Sasano, H., Ishida, T., Miyashita, M., Takeda, M., Amari, M., et al. (2010) Comparison of Core Needle Biopsy (CNB) and Surgical Specimens for Accurate Preoperative Evaluation of ER, PgR and HER2 Status of Breast Cancer Patients. Cancer Science, 101, 2074-2079.