Effect of Needle Size in Ultrasound-guided Core Needle Breast Biopsy: Comparison of 14-, 16-, and 18-Gauge Needles.
The aim of the present study was to assess the diagnostic accuracy of ultrasound-guided core needle biopsy (US-CNB) of breast lesions, comparing smaller needles (16- and 18-gauge) with the 14-gauge needle, and to analyze the lesion characteristics influencing US-CNB diagnostic performance.



All the patients provided informed consent before the biopsy procedure. The data from breast lesions that had undergone US-CNB in our institution from January 2011 to January 2015 were retrospectively reviewed. The inclusion criterion was the surgical histopathologic examination findings of the entire lesion or radiologic follow-up data for ≥ 24 months. The exclusion criterion was the use of preoperative neoadjuvant therapy. The US-CNB results were compared with the surgical pathologic results or with the follow-up findings in the 3 needle size groups (14-, 16-, and 18-gauge). The needle size- and lesion characteristic-specific diagnostic accuracy parameters were evaluated. Statistical analysis was performed using a dedicated software program, and P ≤ .01 was considered significant.



A total of 1118 US-CNB cases (1042 patients) were included. Of the 1118 cases, 630 (56.3%) were in the 14-gauge group, 136 (12.2%) in the 16-gauge, and 352 (31.5%) in the 18-gauge needle group. Surgery was performed on 800 lesions (71.6%). Of these, 619 were malignant, 77 were high risk, and 104 were benign. The remaining 318 lesions (28.4%) underwent follow-up imaging studies. All the lesions were stable and, therefore, were considered benign. No differences were observed in the diagnostic accuracy parameters among the 3 needle size groups (P > .01). The false-negative rate was greater for lesions < 10 mm (7.2%) (P < .01) but without statistically significant differences among the 3 gauges (P > .01).



US-CNB performed with small needles (16 and 18 gauge) had the same diagnostic accuracy as that performed with 14-gauge needles, regardless of the lesion characteristics.
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: micgiuli@yahoo.it.
Michela
M
Giuliani
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
Pierluigi
P
Rinaldi
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
Rossella
R
Rella
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
Gina
G
Fabrizi
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
Federica
F
Petta
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
Giorgio
G
Carlino
Department of General Surgery, Catholic University of the Sacred Heart, Rome, Italy.
Alba
A
Di Leone
Department of Pathologic Anatomy, Catholic University of the Sacred Heart, Rome, Italy.
Antonino
A
Mulè
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
Enida
E
Bufi
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
Maurizio
M
Romani
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
Paolo
P
Belli
Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
Lorenzo
L
Bonomo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D011379:Prognosis; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
Breast; Core needle biopsy; Diagnosis; Needles; Ultrasound