Diagnosis value of ultrasound-guided core-needle biopsy in breast masses under BI-RADS categories 4A to 4C / 中国肿瘤临床

ABSTRACT

Objective:To evaluate the clinical value of ultrasound-guided core-needle biopsy (US-CNB) in the diagnosis of breast lesions under categories 4A to 4C of the second edition of the Breast Imaging Reporting and Data System (BI-RADS) ultrasound lexicon. Meth-odsThe pathological characteristics of 355 patients with breast masses who underwent US-CNB in the Tianjin Medical University Can-cer Institute and Hospital from March 2015 to October 2015 were retrospectively analyzed. Each patient was subjected to postopera-tive pathological examination to confirm diagnosis. Results:According to the US-CNB results, of the 355 patients, 235 were diagnosed with breast cancer, and 120 had benign lesions. Through postoperative pathological examination, 41 of the patients with benign le-sions were confirmed to have breast cancer. The specificity of the US-CNB was 100%in all the categories of breast masses. The sensibil-ities of breast masses under BI-RADS categories 4A, 4B, and 4C were 62.50%, 82.46%, and 89.73%, respectively. The accuracies of the US-CNB in 4A, 4B, and 4C were 84.62%, 87.01%, and 90.74%, correspondingly. Of the 41 patients with false-negative results, 14 had in-traductal carcinoma, 5 had intraductal papillary carcinoma, 3 had mucinous carcinoma, and 19 had invasive ductal carcinoma. Conclu-sionUS-CNB is a safe, reliable, and accurate early diagnostic method for breast masses under the 4B and 4C categories. However, the sensibility of US-CNB was extremely low in patients with breast masses under the 4A category. Thus, final diagnosis should be accom-plished by combining US-CNB with mammography, MRI, or other testing methods. Meanwhile, US-CNB is not recommended for pa-tients with intraductal papillary neoplasms diagnosed through ultrasonography.