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KMID : 1114620090060020115
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Journal of the Korean Society for Breast Screening
2009 Volume.6 No. 2 p.115 ~ p.121
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Analysis of Nonpalpable Breast Lesions that Ultrasonography-guided Core-Needle Biopsy was Canceled
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Han Boo-Kyung
Ko Eun-Young
Shin Jung-Hee
Kang Seok-Seon
Hahn Soo-Yeon
Nam Mee-Young
Hwang Ji-Young
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Abstract
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Purpose: To determine the frequency and the reasons for cancellation of ultrasonography (US)-guided coreneedle biopsy in nonpalpable breast lesions and the US features and the outcome in canceled cases.
Materials and Methods: During 3-years period from January 1999 to December 2001, 946 patients were referred to our radiologic department for US-guided core-needle biopsies of nonpalpable breast lesions by clinicians’ discretion. We searched for canceled core-needle biopsies among them and reviewed their radiologic reports and images. Follow-up data were based on the clinical charts for at least 2 years.
Results: Among the 946 scheduled core biopsy cases, 69 (7.3%) were canceled. The reasons for cancellation were that the target lesion was a cyst (40.6%) or a fat lobule (15.9%), the lesion was not recognized (21.7%), or the lesion was too small or multiple (21.7%). The clinicians recommended core biopsies, based on US images from a different (88.4%) or the same (11.7%) institution. The biopsy-recommended lesions on original US images were mass-like lesions in 63 and nonmass-like hypoechoic lesions in 6. Follow-up revealed two cancers; one around the same lesion after 28 months and the other at a different site.
Conclusion: A cyst or fat lobule is liable to a biopsy target. Unnecessary biopsy can be avoided by an attempt for aspiration of fluid and US reexamination by experts. Before cancellation, comparison with mammography and close follow-up can prevent a delayed diagnosis of cancer.
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KEYWORD
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Breast Ultrasonography, Biopsy, Pseudolesion
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