The Value Of Ultrasound-Guided Core Needle Biopsy In Diagnosis Of Nonpalpable Breast Lesions (Diameter≤5mm)

The value of ultrasound-guided core needle biopsy in diagnosis of nonpalpable breast lesions (diameter≤5mm)Objective:The objective of this study was to investigate the clinical value for ultrasound-guided core needle biopsy (US-CNB) in diagnosis of nonpalpable breast lesions (diameter<5mm) with calcification.Methods:To collect the suspicious nonpalpable breast lesions under ultrasound in our hospital,56 patients with 56 nonpalpable breast lesions were enforced to US-CNB from November 2009 to February 2011, then we analysed pathological feature of the tissues. The questionable lesions and malignant lesions were under immunohistochemical analysis. The malignant lesions in patients were removed by surgery directly or underwent neoadjuvant chemotherapy before surgery, patients with benign lesions were carried out regular follow-ups including breast ultrasound examinations of once every 3 months and mammograms of once a year.Finally we evaluate the clinical value of US-CNB in nonpalpable breast lesions with calcification.Result:(1)51 patients with calcified breast micro-lesions have successful puncture,5 cases failed to confirm the diagnosis. Pathological diagnosis: there are 11 malignant lesions, including 6 infiltrating ductal carcinoma,1 infiltrating lobular carcinoma,1 intraductal carcinoma with microinvasion,2 intraductal carcinoma, lmucinous carcinoma. Besides, there are 40 benign lesions, including 16 galactocele with ductal ectasia,9 breast fibroma,7 intraductal papilloma,3 fiber adenomatous hyperplasia,4 mastopathia,1 gynecomastia. The rate of diagnosis by US-CNB in impalpable breast lesions with calcification is 91.1%, No infection, hematoma, pneumothorax and other complications occurred.(2)The detection rate of microcalcifications in 11 cases of breast cancer and 40 cases of benign breast lesion were 73.6%(7/11) and 22.5%(9/40), respectively; it shows significant difference between both (P<0. 05).(3)In 11 biopsy specimens Of malignant lesions, we got 8 cases with ER-positive,7 with cases PR-positive,3 cases with Herb-2 positive, the positive expression rates of ER, PR and Herb-2were were 72.7%, 63.6%, 27.3%, respectively. (4)45 patients of whole group were followed up. Deadline February 28,2011,12 patients were followed up more than 12 months, with four ultrasounds and one mammography examination.7 cases were followed up for more than 9 months, with 3 ultrasounds.11 cases were followed up for more than 6 months, with two ultrasounds.4 cases were followed up for more than 3 months, with one ultrasound examination.4 patients were followed up for less than 3 months.7 patients lost to follow-up. At present,38 patients were in the observation phase with stable condition, without giving any clinical management.Conclusion:(1)US-CNB is an effective method for diagnosis of NPBL (diameter<5mm), with high diagnostic accuracy, safe, minimally invasive, rapid, economica. It can be used as the preferred method for early diagnosis of breast cancer.(2)US-CNB is an effective method in detecting the IHC results of the breast cancer before surgery, and the patients of malignant diseases will have the opportunity to conserve the breast.