title: The negative predictive value of ultrasound-guided 14-gauge core needle biopsy of breast masses: a validation study of 339 cases.
abstract: OBJECTIVE
  To determine the negative predictive value of sonographically guided 14-gauge core needle biopsy of breast masses, with detailed analysis of any false-negative cases.
  
  
  METHODS
  We reviewed 669 cases of sonographically guided 14-gauge core needle biopsies that had benign pathologic findings. Given a benign pathology on core biopsy, true-negatives had either benign pathology on surgical excision or at least 2 years of stable imaging and/or clinical follow-up; false-negatives had malignant histology on surgical excision.
  
  
  RESULTS
  Follow-up was available for 339 breast lesions; 117 were confirmed to be benign via surgical excision, and 220 were stable after 2 years or more of imaging or clinical follow-up (mean follow-up time 33.1 months, range 24-64 months). The negative predictive value was determined to be 99.4%. There were 2 false-negative cases, giving a false-negative rate of 0.1%. There was no delay in diagnosis in either case because the radiologist noted discordance between imaging and core biopsy pathology, and recommended surgical excision despite the benign core biopsy pathology.
  
  
  CONCLUSIONS
  Sonographically guided 14-gauge core needle biopsy provides a high negative predictive value in assessing breast lesions. Radiologic/pathologic correlation should be performed to avoid delay in the diagnosis of carcinoma.
authors.affiliation: Vancouver Breast Center, Department of Radiology, University of British Columbia, Suite 505, 750 West Broadway, Vancouver, BC V5Z1H4, Canada. charliezhang825@hotmail.com
authors.forename: Charlie
authors.initials: C
authors.lastname: Zhang
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Lewis
authors.forename: Paola
authors.initials: P
authors.lastname: Nasute
authors.forename: Malcolm
authors.initials: M
authors.lastname: Hayes
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Warren
authors.forename: Paula B
authors.initials: PB
authors.lastname: Gordon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004867:Equipment Design; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary / Q000379:methods*