title: Diagnostic accuracy of ultrasonography-guided core needle biopsy for breast lesions.
abstract: BACKGROUND
  This study aimed to assess the diagnostic accuracy of ultrasonography (US)-guided core needle biopsy (CNB) for breast lesions.
  
  
  METHODS
  We performed US-guided CNB of 733 lesions in 674 women from January 2003 to December 2005. Surgical excision was performed on 331 lesions. We compared the histopathologic findings of the CNB specimens with those of surgical specimens or with patients' long-term follow-up images. We also calculated the agreement, underestimation, sensitivity and false-negative rates.
  
  
  RESULTS
  The CNB results showed 334 breast cancers (46%), 28 high-risk lesions (5%) and 367 benign lesions (50%). Four (1%) lesions were categorised as inconclusive. The final diagnosis was breast cancer in 348 lesions. The kappa measure of agreement between the US-guided CNB results and surgical excision findings or follow-up results was 0.861 (p-value < 0.001). The underestimation rate was 40% (10 out of 25) for atypical ductal hyperplasia and 47% (14 out of 30) for ductal carcinoma in situ (DCIS). The CNB false negative rate and sensitivity for malignant lesions was 4% (14 out of 348) and 96% (334 out of 348), respectively.
  
  
  CONCLUSIONS
  US-guided CNB is an accurate diagnostic alternative to surgical biopsy in patients with breast lesions detected via US, although the high underestimation rates in DCIS and high-risk lesions are still a concern.
authors.affiliation: Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rajthewee, Bangkok, Thailand. racwr@mahidol.ac.th
authors.forename: C
authors.initials: C
authors.lastname: Wiratkapun
authors.forename: T
authors.initials: T
authors.lastname: Treesit
authors.forename: B
authors.initials: B
authors.lastname: Wibulpolprasert
authors.forename: P
authors.initials: P
authors.lastname: Lertsithichai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014463:Ultrasonography / Q000379:methods*