Role of Image-Guided Biopsy in Nonpalpable Breast Lesions: A Study in the Sub-Himalayan Region of North India

Abstract

Background

Nonpalpable breast lesions pose a challenge in their early diagnosis. Image-guided biopsy is preferred in these cases so that a pathological diagnosis of breast carcinoma is reached timely for a better prognosis as the disease has an increased chance of successful outcome with early identification and treatment.

Objective

The study aims at evaluating the role of stereotactic core needle biopsy (CNB) and percutaneous ultrasound-guided core needle biopsy (US-CNB) in diagnosing suspicious nonpalpable breast lesions.

Methods

Our study included 35 patients with nonpalpable breast lesions and having a Breast Imaging Reporting and Data System (BI-RADS) risk assessment category IV or V on mammography or sonography. These 35 lesions were subjected to percutaneous image-guided (stereotactic or US) biopsy for histopathological analysis.

Results

Out of a total of 35 cases, 17 were pathologically malignant (48.6%), with the most common subtype being invasive ductal carcinoma (82.3%). Twenty-nine cases underwent US-CNB, 16 (55.1%) of which were malignant and 13 (44.8%) were benign on histopathological evaluation (HPE). The remaining six cases, which on mammography showed no mass but suspicious malignant calcification only, were subjected to stereotactic CNB, out of which one (16.6%) was malignant and five (83.3%) were benign on HPE. Hence, the lesions visible on sonography were more likely to be malignant.

Conclusion

Sonography and mammography play a complimentary role in detecting breast carcinoma. Percutaneous biopsy under image guidance can be used as an accurate diagnostic alternative to open surgical excisional biopsy to avoid diagnostic delay.

Keywords

breast cancer - ultrasound-guided core needle biopsy - stereotactic core needle biopsy - Breast Imaging Reporting and Data System - histopathology

Authors' Contributions

C.S.T. and S.M. developed the study concept and design. S.P.S., C.S.T., and N.S. contributed to data acquisition. S.P.S., S.K., and S.T. analyzed the data. S.T. and S.P.S. drafted the manuscript. A.J. and N.A. contributed to critical revision of the manuscript. All authors read and approved the final manuscript.

Publikationsverlauf

Eingereicht: 22. Juni 2024

Angenommen: 21. September 2024

Artikel online veröffentlicht:
29. Oktober 2024

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