Ultrasound-guided core needle biopsy as an initial diagnostic test for palpable breast masses

PURPOSE: To determine the role of ultrasound (US)-guided core needle biopsy as an initial diagnostic test for palpable breast masses. MATERIALS AND METHODS: Ninety-eight consecutive patients, each with a palpa ble breast mass, were referred for US-guided core biopsy by a multidiscipli nary team of physicians who specialize in the care of breast diseases. All palpable breast masses were clearly visible on high-resolution US. Ninety-n ine core needle biopsies were performed under local anesthesia with use of freehand technique, mostly in an outpatient setting. Core needle path throu gh each mass was documented in two orthogonal sections. A mean of 3.4 tissu e core samples (range, 1-7) were obtained in each patient. RESULTS: Core needle biopsy resulted in the diagnosis of 66 malignancies, t wo cases of atypical ductal hyperplasia (ADH), and 30 benign diseases of th e breast. Surgery with curative intent was performed in 63 breast malignanc ies and excisional biopsies were performed for 10 benign diseases (two case s of ADH and eight benign lesions). Twenty-five breast masses were managed nonoperatively: chemotherapy, was performed in three locally advanced breas t cancers and 3-year follow-up was conducted for 22 benign lesions. Maligna ncies were correctly diagnosed in all cases. No malignancy was discovered a t surgery or during clinical follow-up of ADH and no benign breast lesions were diagnosed by core needle biopsy. US-guided core needle biopsy is 100% sensitive and specific for palpable breast malignancies, with no false-posi tive results. A puncture site ecchymosis was the only morbidity! or complic ation noted. CONCLUSION: US-guided core needle biopsy is a safe and accurate first diagn ostic test for palpable breast masses that require tissue proof.