US-guided 14G Core Needle Biopsy: Comparison Between Underestimated and Correctly Diagnosed Breast Cancers

Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoingultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated andaccurately diagnosed groups. Materials and
Methods: Of 1,898 cases of US-guided 14G CNB in our institute,233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductalcarcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctlydiagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breastcancers were compared.
Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Amongunderestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB provenADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results wereIDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADScategory, margin of mass on mammography and US and orientation of lesion on US revealed statistically significantdifferences.
Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Betweenunderestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography andmargin and orientation of the lesions on US were different.