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CC BY 4.0 · Journal of Clinical Interventional Radiology ISVIR
DOI: 10.1055/s-0045-1813656
Original Article

Analysis of US-Guided Core Needle Biopsy of Breast Lesions in a Tertiary Cancer Centre

Authors

  • Palak B. Thakkar Popat

    1   Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Renuka Ashtekar

    1   Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Nitin Shetty

    1   Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Kunal Gala

    1   Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Meenakshi Thakur

    1   Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Aparna Katdare

    1   Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Purvi Haria

    1   Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Sonal Chauhan

    1   Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Tanuja Shet

    2   Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Shalaka Joshi

    3   Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Sudeep Gupta

    4   Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Rajiv Sarin

    5   Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

  • Suyash Kulkarni

    1   Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Abstract

Purpose

Preoperative diagnosis of breast lesions is typically performed using ultrasound (US)-guided core needle biopsy (CNB), and this study analyses factors impacting its performance.

Methods

This study retrospectively analyzed CNBs conducted over 63 months at a tertiary cancer center to assess diagnostic accuracy (DA) and factors influencing biopsy success, including radiologists' experience, needle gauge size, number of cores, and strain elastography.

Results

Of 868 technically successful biopsies, 25 were diagnostically unsuccessful, yielding an overall diagnostic success rate of 97.1%. A statistically significant difference (p < 0.001) was observed between 14G and 18G needles, with diagnostic success improving from 94.4 to 99.8% using 14G needles. Combining Breast Imaging Reporting and Data System (BI-RADS) with elastography improved DA for benign lesions from 93.2 to 95.7% and for suspicious lesions (BI-RADS 4C/5) from 93.5 to 97.4%. In radio-pathologically discordant BI-RADS 4C/5 cases, malignancy was found in 17.5% (n = 7) upon surgical excision or clinical follow-up, highlighting the need for rebiopsy in discordant cases. The false-negative rate was 0.9%.

Conclusion

Overall, US-guided CNB demonstrated high DA, with sensitivity, specificity, and accuracy of 98.4, 100, and 98.8%, respectively—comparable to global standards. Implementing practice-enhancing measures, such as using 14G needles and ensuring that radiologists trained in breast imaging perform biopsies, can further improve technical and diagnostic success.

Keywords

BI-RADS - core needle biopsy - diagnostic accuracy - elastography - VABB


Publication History

Article published online:
09 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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