A comparison of two microinvasive biopsy procedures in sonographically highly suspicious breast malignancies / 中华普通外科杂志

ABSTRACT

Objective To evaluate the value of fine needle aspiration (FNA) and core needle biopsy (CNB) in highly suspicious breast malignant lesions in terms of diagnostic accuracy,complication rate and cost-effectiveness.Methods We retrospectively reviewed records of patients with imaging diagnosis of BI-RADS 4c or 5 categories who have undergone either FNA or CNB under ultrasound guidance in Peking University People's Hospital from 2012 to 2014.Sensitivity,specificity,diagnostic accuracy,positive predictive,negative predictive,false positive rate,false negative rate,accuracy rate and unsatisfactory rate (non-diagnostic rate) were calculated and compared between FNAC and CNB.The complication of the procedures,operation time and cost were assessed.Results Among 638 consecutive cases,273 of them underwent FNA,and 365 underwent CNB.The accuracy rate of FNA and CNB were 99％ and 97.2％.The sensitivity,specificity,diagnostic accuracy,positive predictive,false positive rate and false negative rate were similar between the two groups.The unsatisfactory rate of FNA was significantly higher than that of CNB (25.3％ vs.10.9％,x2 =22.59,P =0.000).There was not severe complication in either groups,while subcutaneous ecchymosis and hematoma were more common in FNA group than in CNB group.The operation time of FNA was shorter than that of CNB (4.8 ± 1.3 min vs.15.5-± 1.7 min,P =0.000).The waiting time for final pathological report was shorter in patients undergoing FNA (1 vs.3 days).An estimated cost for FNA was RMB 447.5 Yuan/case,whereas that was 995 Yuan/case for CNB.Conclusions FNA and CNB are both accurate and safe preoperative diagnostic procedures.FNA is a simple and cost-effective method.