Rates of pathological underestimation for 9 and 12 gauge breast needle core biopsies at surgical excision
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
The clinical implementation of needle core biopsies has given radiologists an invaluable tool for the diagnostic evaluation of suspicious breast lesions. Despite improvements made to the technology of breast biopsy, the underestimation of disease in tissue samples retrieved continues. This can be attributed to many factors, including variability between different needle gauges. This study was undertaken to assess the pathological underestimation for 9 and 12 gauge breast needle core biopsies at surgical excision.
Materials and methods
A retrospective review of image-guided consecutive core needle biopsies performed from 2003 to 2006 yielded a total of 1,201 needle core biopsies: 837 twelve gauge and 364 nine gauge. Further analysis was completed to distinguish needle biopsies whose pathological outcome was underestimated at core needle biopsy when compared to their subsequent surgical excision. Ninety-seven lesions in 88 patients were reviewed and comprise the study cohort.
Underestimation was found in 97 needle core procedures in 88 patients. Of the 97, 67 were performed with 12 gauge vacuum-assisted biopsy devices and 30 with 9 gauge vacuum-assisted biopsy devices, resulting in an underestimation rate of 8.00 and 8.24% for 12 gauge and 9 gauge, respectively. The difference in underestimation rate was not statistically significant per Pearson’s chi squared test (P = 0.8898).
In this analysis, the underestimation of needle biopsy results with surgical pathology was found to be 8.00% for the 12 gauge group and 8.24% for the 9 gauge group. These results support our current clinical practice of utilizing either needle gauge.
- Liberman L, Bracero N, Vuolo M, Dershaw DD, Morris EA, Abramson AF, et al. Percutaneous large-core biopsy of papillary breast lesions. AJR Am J Roentgenol. 1999;172:331–7.
- Schueller G, Jaromi S, Ponhold L, Fuchsjaeger M, Memarsadeghi M, Rudas M, et al. US-guided 14-gauge core-needle breast biopsy: results of a validation study in 1352 cases. Radiology. 2008;248:406–13. CrossRef
- Youk JH, Kim EK, Kim MJ, Oh KK. Sonographically guided 14-gauge core needle biopsy of breast masses: a review of 2,420 cases with long-term follow-up. AJR Am J Roentgenol. 2008;190:202–7. CrossRef
- Burak WE, Owens KE, Tighe MB, Kemp L, Dinges SA, Hitchcick C, et al. Vacuum-assisted stereotactic breast biopsy. Arch Surg. 2000;135:700–3. CrossRef
- Rakha EA, Ellis IO. An overview of assessment of prognostic and predictive factors in breast cancer needle core biopsy specimens. J Clin Pathol. 2007;60:1300–6. CrossRef
- Margolin FR, Leung JW, Jacobs RP, Denny SR. Percutaneous imaging-guided core breast biopsy; 5 years’ experience in a community hospital. AJR Am J Roentgenol. 2001;177:559–64.
- Heywang-Kobrunner SH, Schaumloffel U, Viehweg P, Hofer H, Buchmann J, Lampe D. Minimally invasive stereotaxic vacuum core breast biopsy. Eur Radiol. 1998;8:377–85. CrossRef
- Brem RF, Schoonjans JM, Goodman SN, Nolton A, Askin FB, Gatewood OM. Nonpalpable breast cancer: percutaneous diagnosis with 11- and 8-gauge stereotactic vacuum-assisted biopsy devices. Radiology. 2001;219:793–6.
- Lourenco AP, Mainiero MB, Lazarus E, Giri D, Schepps B. Stereotactic breast biopsy: comparison of histologic underestimation rates with 11- and 9- gauge vacuum-assisted breast biopsy. AJR Am J Roentgenol. 2007;189:W275–9. CrossRef
- Darling ML, Smith DN, Lester SC, Kaelin C, Selland DG, Denison CM, et al. Atypical ductal hyperplasia and ductal carcinoma in situ as revealed by large-core needle breast biopsy: results of surgical excision. AJR Am J Roentgenol. 2000;175:1341–6.
- Jang M, Cho N, Moon WK, Park JS, Seong MH, Park IA. Underestimation of atypical ductal hyperplasia at sonographically guided core biopsy of the breast. AJR Am J Roentgenol. 2008;191:1347–51. CrossRef
- Liberman L, Hollan AE, Marjan D, Murray MP, Bartella L, Morris EA, et al. Underestimation of atypical ductal hyperplasia at MRI-guided 9-gauge vacuum-assisted breast biopsy. AJR Am J Roentgenol. 2007;188:684–90. CrossRef
- Jackman RJ, Burbank F, Parker SH, Evans WP, Lechner MC, Richardson TR, et al. Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates. Radiology. 2001;218:497–502.
- Jackman RJ, Burbank F, Parker SH, Phil EW, Lechner MC, Richardson TR, et al. Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted biopsy. Radiology. 1997;204:484–8.
- Philpotts LE, Lee CH, Horvath LJ, Lange RC, Carter D, Tocino I. Underestimation of breast cancer with 11-gauge vacuum-suction biopsy. AJR Am J Roentgenol. 2000;175:1047–50.
- Burbank F. Stereotactic breast biopsy of atypical ductal hyperplasia and ductal carcinoma in situ lesions: improved accuracy with directional vacuum-assisted biopsy. Radiology. 1997;202:843–7.
- Philpotts LE, Shaheen NA, Carter D, Lange RC, Lee CH. Comparison of re-biopsy rates after stereotactic core needle biopsy of the breast with 11-gauge vacuum suction probe versus 14-gauge needle and automated gun. AJR Am J Roentgenol. 1998;172:683–7.
- Philpotts LE, Hooley RJ, Lee CH. Comparison of automated versus vacuum-assisted biopsy methods for sonographically guided core biopsy of the breast. AJR Am J Roentgenol. 2003;180:347–51.
- Rates of pathological underestimation for 9 and 12 gauge breast needle core biopsies at surgical excision
Volume 18, Issue 1 , pp 42-50
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Breast imaging
- Core needle biopsy
- Vacuum-assisted biopsy
- Industry Sectors