Abstract
Objective
To compare the diagnostic accuracy of ultrasound (US)-guided core needle biopsy (CNB) of breast masses performed with 14-gauge, 16-gauge and 18-gauge needles.
Methods
We retrospectively reviewed the charts of 1,112 patients who underwent US-guided breast CNB with 14-gauge, 16-gauge and 18-gauge needles. Cases with surgical excision or a minimum of 2 years of imaging follow-up were included. Rates of sample inadequacy, discordance with surgical or imaging findings and upgrade of DCIS to invasive cancer or high-risk lesion to in situ or invasive cancer were computed for each needle size.
Results
The study included 703 CNBs: 203 performed with 14-gauge, 235 with 16-gauge and 265 with 18-gauge needles. There were no significant differences between 14-gauge, 16-gauge and 18-gauge needles in rates of specimen inadequacy (0 %, 0.4 % and 1.9 %, respectively) (p = 0.084); surgical discordance (2.6 %, 2.9 % and 3.8 %) (p = 0.76); imaging discordance (0 %, 0 % and 2 %) (p = 1.0); DCIS upgrade (43 %, 43 % and 36 %) (p = 1.00) or high-risk lesion upgrade (38 %, 25 % and 55 %) (p = 0.49).
Conclusion
There was no statistically significant difference in diagnostic accuracy of US-guided CNB of breast masses performed with 14-gauge, 16-gauge and 18-gauge needles.
Key Points
• Percutaneous image-guided breast core needle biopsy (CNB) is the standard of care.
• Breast CNB with 14-gauge, 16-gauge and 18-gauge needles has similar diagnostic accuracy.
• Smaller gauge needles can be confidently used for ultrasound-guided breast CNB.
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References
Parker SH, Lovin JD, Jobe WE et al (1990) Stereotactic breast biopsy with a biopsy gun. Radiology 176:741–747
Parker SH, Burbank F, Jackman RJ et al (1994) Percutaneous large-core breast biopsy: a multi-institutional study. Radiology 193:359–364
Fornage BD (1999) Sonographically guided needle biopsy of nonpalpable breast lesions. J Clin Ultrasound 27:385–398
Mendelson EB, Böhm-Vélez M, Berg WA et al. (2013) ACR BI-RADS Ultrasound. In: ACR BI-RADS Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology
Krishnamurthy S, Bevers T, Kuerer H et al (2012) Multidisciplinary considerations in the management of high-risk breast lesions. AJR Am J Roentgenol 198:W132–W140
Nath ME, Robinson TM, Tobon H et al (1995) Automated large-core needle biopsy of surgically removed breast lesions: comparison of samples obtained with 14-, 16-, and 18-gauge needles. Radiology 197:739–742
Helbich TH, Rudas M, Haitel A et al (1998) Evaluation of needle size for breast biopsy: comparison of 14-, 16-, and 18-gauge biopsy needles. AJR Am J Roentgenol 171:59–63
Nguyen M, McCombs MM, Ghandehari S et al (1996) An update on core needle biopsy for radiologically detected breast lesions. Cancer 78:2340–2345
Schoonjans JM, Brem RF (2001) Fourteen-gauge ultrasonographically guided large-core needle biopsy of breast masses. J Ultrasound Med 20:967–972
Smith DN, Rosenfield Darling ML, Meyer JE et al (2001) The utility of ultrasonographically guided large-core needle biopsy: results from 500 consecutive breast biopsies. J Ultrasound Med 20:43–49
Crystal P, Koretz M, Shcharynsky S et al (2005) Accuracy of sonographically guided 14-gauge core-needle biopsy: results of 715 consecutive breast biopsies with at least two-year follow-up of benign lesions. J Clin Ultrasound 33:47–52
Schueller G, Jaromi S, Ponhold L et al (2008) US-guided 14-gauge core-needle breast biopsy: results of a validation study in 1352 cases. Radiology 248:406–413
Youk JH, Kim EK, Kim MJ et al (2008) 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 190:202–207
Margolin FR, Leung JW, Jacobs RP et al (2001) Percutaneous imaging-guided core breast biopsy: 5 years’ experience in a community hospital. AJR Am J Roentgenol 177:559–564
Uematsu T, Kasami M, Uchida Y et al (2007) Ultrasonographically guided 18-gauge automated core needle breast biopsy with post-fire needle position verification (PNPV). Breast Cancer 14:219–228
Lai HW, Wu HK, Kuo SJ et al (2013) Differences in accuracy and underestimation rates for 14- versus 16-gauge core needle biopsies in ultrasound-detectable breast lesions. Asian J Surg 36:83–88
Zhou JY, Tang J, Wang ZL et al (2014) Accuracy of 16/18G core needle biopsy for ultrasound-visible breast lesions. World J Surg Oncol 12:7
Brenner JR, Fajardo L, Fisher PR et al (1996) Percutaneous core biopsy of the breast: effect of operator experience and number of samples on diagnostic accuracy. AJR Am J Roentgenol 166:341–346
Kirshenbaum K, Keppke A, Hou K et al (2012) Reassessing specimen number and diagnostic yield of ultrasound guided breast core biopsy. Breast J 18:464–469
Perrot N, Jalaquier-Coudray A, Frey I et al (2013) US-guided core needle biopsy: false-negatives. How to reduce them? Eur J Radiol 82:424–426
de Lucena CE, Dos Santos Junior JL, de Lima Resenda CA et al (2007) Ultrasound-guided core needle biopsy of breast masses: how many cores are necessary to diagnose cancer? J Clin Ultrasound 35:363–366
Park AY, Gweon HM, Son EJ et al (2014) Ductal carcinoma in situ diagnosed at US-guided 14-gauge core-needle biopsy for breast mass: preoperative predictors of invasive breast cancer. Eur J Radiol 83:654–659
Philpotts LE, Hooley RJ, Lee CH (2003) Comparison of automated versus vacuum-assisted biopsy methods for sonographically guided core biopsy of the breast. AJR Am J Roentgenol 180:347–351
Mesurolle B, Perez JC, Azzumea F et al (2014) Atypical ductal hyperplasia diagnosed at sonographically guided core needle biopsy: frequency, final surgical outcome, and factors associated with underestimation. AJR Am J Roentgenol 202:1389–1394
Houssami N, Ciatto S, Ellis I et al (2007) Underestimation of malignancy of breast core-needle biopsy: concepts and precise overall and category-specific estimates. Cancer 109:487–495
Acknowledgments
The scientific guarantor of this publication is Monica L. Huang, MD. The authors declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained for this retrospective study.
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Huang, M.L., Hess, K., Candelaria, R.P. et al. Comparison of the accuracy of US-guided biopsy of breast masses performed with 14-gauge, 16-gauge and 18-gauge automated cutting needle biopsy devices, and review of the literature. Eur Radiol 27, 2928–2933 (2017). https://doi.org/10.1007/s00330-016-4651-5
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DOI: https://doi.org/10.1007/s00330-016-4651-5