Diagnostic Accuracy of Vacuum-Assisted Stereotactic Core Needle Biopsy for Breast Lesions
Cholatip Wiratkapun MD*, Ekkapong Fusuwankaya MD*, Bussanee Wibulpholprasert MD*, Panuwat Lertsittichai MD, MSc**
Affiliation : * Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate the diagnostic accuracy of the vacuum-assisted stereotactic core needle biopsy (CNB) for breast
lesions.
Material and Method: Sixty-four lesions that had undergone vacuum-assisted stereotactic CNB between January 2003 and
December 2005 in Ramathibodi Breast diagnostic center were included in this study. Pathologic results of CNB were reviewed
and correlated with pathologic results of subsequent open surgery. For benign lesions without surgery, the authors correlated
the result of CNB with stability of the lesion at or more than 2-year interval follow-up. Agreement rate, high-risk under
estimate rate, Ductal carcinoma in situ (DCIS) underestimate rate, false negative rate, and sensitivity were accessed.
Results : The pathologic results for the CNB were malignancy in 20%, high-risk in 13%, and benign in 67%. The agreement
rate was 93.8% (60 of 64). The under estimate rate for atypical ductal hyperplasia (ADH) was 50% (3 of 6). There was no
underestimate for DCIS in the present study. Of 43 benign lesions, malignancy was found at subsequent open surgery in one
lesion and false negative rate was 6%. Calculated sensitivity was 96%.
Conclusion : Vacuum-assisted CNB is an accurate method for evaluating breast lesions. This procedure is an alternative to
surgical excision for lesion assessments.
Keywords : Stereotactic core needle biopsy, Breast lesions, Breast cancer, Underestimation rate, Diagnostic accuracy
