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Ultrasound-Guided Core Needle Biopsy of Breast Lesions: Results and Usefulness in a Low Income Country

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Document pages: 10 pages

Abstract: Background: Core needle biopsy (CNB) under ultrasound guidance is an accepted standard of care for the diagnosis of breast lesions. It is safe, cost-effective and minimally invasive compared with surgical excision. Objective: The aim of this study was to evaluate the CNB’s results regarding the procedure, complications, histopathological findings and their correlation with the imaging data and surgical histopathological findings. Method: A cross-sectional prospective and descriptive study of a consecutive series of ultrasound-guided CNB of breast lesions in women conduced from January 2015 to December 2016 at the Sylvanus Olympio university hospital of Lomé, in Togo. Results: There were 72 CNB performed under ultrasound guidance in women; from which 54 were retained for the study. The mean age was 44.9 years ± 9.8. 11.1 had a family history of breast cancer. Lesions were most often palpable (90.7 ). They were located in the left breast in 54.7 . Lesions were categorized probably malignant or malignant (Birads 4 and 5) in 70.4 and probably benign (Birads 3) in 29.6 . Their mean size was 24.8 mm ± 7.6 at ultrasound. There were no major complications during the procedure. One CNB (1.9 ) considered inconclusive was repeated. Histologically, invasive ductal carcinoma (61.1 ) was the most common lesion. Fifty-three women underwent surgical procedure and histopathological confirmation. Ultrasound-guided CNB had a sensitivity of 97.5 , specificity of 100 , positive predictive value of 100 , negative predictive value of 92.8 , and an overall diagnostic accuracy of 98.1 . Breast Imaging Reporting and Data System (Birads) categorization had a sensitivity of 94.8 , specificity of 100 , positive predictive value of 100 , negative predictive value of 87.4 , and diagnostic accuracy of 96.2 . Conclusion: Ultrasound guided CNB represent accurate methods for the characterization of breast lesions, with high values of diagnostic accuracy, sensitivity, specificity and negative predictive value. It does not involve a major complication, even in tropical environments.

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