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Ultraschall Med 2012; 33(7): E145-E150
DOI: 10.1055/s-0032-1313208
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Is US-guided Core Needle Biopsy (CNB) enough in Probably Benign Nodules with Interval Growth?

Ist bei mutmaßlich gutartigen Knoten mit Intervallwachstum die US-gestützte Feinnadelbiopsie (CNB) ausreichend?
J. H. Yoon
1   Department of Radiology, CHA Bundang Medical Center, CHA University, School of Medicine
,
E.-K. Kim
2   Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine
,
J. Y. Kwak
2   Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine
,
H. J. Moon
2   Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine
,
M. J. Kim
2   Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine
› Author Affiliations
Further Information

Publication History

24 May 2012

25 July 2012

Publication Date:
21 September 2012 (online)

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Abstract

Purpose: To investigate whether ultrasound-guided 14-gauge core needle biopsy (US-CNB) is efficient in the diagnosis of probably benign lesions showing interval growth on follow-up US. 

Materials and Methods: From March 2008 to August 2009, 116 breast lesions in 113 women (mean age: 41.2 years, range: 19 – 63 years) which were initially assessed as category 3 showing interval growth on follow-up US underwent US-CNB, and subsequent US-guided vacuum-assisted excision, surgical excision or follow-up US for at least 12 months. Diagnostic performances of US-CNB were evaluated with histopathologic results and follow-up US as standard reference. Clinical features of the patient and lesions characteristics including follow-up interval (I), the most increased diameter (D), D per I, increased volume (%V) and %V per I were calculated and compared.

Results: Of the 116 lesions, 4 lesions were diagnosed as malignancy and 112 as benign on final pathology. Malignancy rate of probably benign lesions showing interval growth was 3.4 % (4/116). Incorrect biopsy rate was 0.9 % (1/116). Palpability or newly developed suspicious US features were more associated with malignancy, 75.0 to 13.4 % and 50.0 to 25.9 %, respectively, but without significance (p = 0.063 and 0.290). Significant differences were seen in average rank when comparing between benign and malignancy in D, %V, D per follow-up interval (I), and %V/I (p = 0.037, 0.017, 0.043 and 0.009, respectively).

Conclusion: US-CNB is an efficient diagnostic method for probably benign lesions showing interval growth, with discordant biopsy rate of 0.9 %.

Zusammenfassung

Ziel: Untersuchung, ob die ultraschallgestützte 14-Gauge-Feinnadelbiopsie (US-CNB) in der Lage ist, mutmaßlich gutartige Läsionen, die bei US-Folgeuntersuchungen mit Intervallwachstum aufweisen, zu diagnostizieren.

Material und Methoden: Von März 2008 bis August 2009 wurde bei 116 Brustläsionen von 113 Frauen (mittleres Alter: 41,2 Jahre, Bereich: 19 – 63 Jahre), die zuerst als Kategorie 3 bewertet wurden und im Folge-US ein Intervallwachstum zeigten, eine US-CNB durchgeführt sowie eine darauffolgende US-gestützte Vakuumexzision, eine chirurgische Exzision und US-Folgeuntersuchungen über mindestens 12 Monate. Die diagnostische Leistungsfähigkeit der US-CNB wurde zusammen mit den histopathologischen Befunden und dem Folge-US als Bezugsstandard ausgewertet. Die klinischen Merkmale der Patienten und die Charakterisierung der Läsionen einschließlich des Folgeintervalls (I), des maximal vergrößerten Durchmessers (D), D pro I, des gestiegenen Volumens (%V) und %V pro I wurden berechnet und verglichen.

Ergebnisse: Von den 116 Läsionen wurden bei der abschließenden pathologischen Untersuchung 4 als maligne und 112 als gutartig diagnostiziert. Die Malignitätsrate der mutmaßlich benignen Läsionen, die ein Intervallwachstum zeigten, betrug 3,4 % (4/116). Die Rate an inkorrekten Biopsien betrug 0,9 % (1/116). Eine Tastbarkeit war mit 75,0 zu 13,4 % und neu aufgetretene, auffällige US-Merkmale waren mit 50 zu 25,9 % häufiger mit Malignität assoziiert, jedoch ohne statistische Signifikanz (p = 0,063 und 0,290). Statistisch signifikante Unterschiede wurden bei der Durchschnittsbewertung gesehen, wenn Gutartigkeit und Malignität in den Parametern D (p = 0,037), %V (p = 0,017), D pro Folgeintervall (I) (p = 0,043) und %V/I (p = 0,009) miteinander verglichen wurden.

Schlussfolgerung: US-CNB ist eine wirksame Methode, um mutmaßlich gutartige Läsionen, die ein Intervallwachstum aufweisen, zu diagnostizieren, mit einem Anteil von 0,9 % an nicht übereinstimmenden Biopsien.

Key words

breast - biopsy - ultrasound - BI-RADS
 

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