Korean J Radiol.  2020 Mar;21(3):259-267. 10.3348/kjr.2019.0695.

Annual Trends in Ultrasonography-Guided 14-Gauge Core Needle Biopsy for Breast Lesions

Affiliations
  • 1Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ekkim@yuhs.ac
  • 2Department of Radiology and Research Institute of Radiological Science, Yonsei Biomedical Research Institute, Seoul, Korea.

Abstract


OBJECTIVE
To examine time trends in ultrasonography (US)-guided 14-gauge core needle biopsy (CNB) for breast lesions based on the lesion size, Breast Imaging-Reporting and Data System (BI-RADS) category, and pathologic findings.
MATERIALS AND METHODS
We retrospectively reviewed consecutive US-guided 14-gauge CNBs performed from January 2005 to December 2016 at our institution. A total of 22,297 breast lesions were included. The total number of biopsies, tumor size (≤ 10 mm to > 40 mm), BI-RADS category (1 to 5), and pathologic findings (benign, high risk, ductal carcinoma in situ [DCIS], invasive cancer) were examined annually, and the malignancy rate was analyzed based on the BI-RADS category.
RESULTS
Both the total number of US scans and US-guided CNBs increased while the proportion of US-guided CNBs to the total number of US scans decreased significantly. The number of biopsies classified based on the tumor size, BI-RADS category, and pathologic findings all increased over time, except for BI-RADS categories 1 or 2 and category 3 (odds ratio [OR] = 0.951 per year, 95% confidence interval [CI]: 0.902, 1.002 and odds ratio = 0.979, 95% CI: 0.970, 0.988, respectively). Both the unadjusted and adjusted total malignancy rates and the DCIS rate increased significantly over time. BI-RADS categories 4a, 4b, and 4c showed a significant increasing trend in the total malignancy rate and DCIS rate.
CONCLUSION
The malignancy rate in the results of US-guided 14-gauge CNB for breast lesions increased as the total number of biopsies increased from 2005 to 2016. This trend persisted after adjusting for the BI-RADS category.

Keyword

Breast cancer; Ultrasonography; Image-guided biopsy; Trends

MeSH Terms

Biopsy
Biopsy, Large-Core Needle*
Breast Neoplasms
Breast*
Carcinoma, Intraductal, Noninfiltrating
Image-Guided Biopsy
Information Systems
Odds Ratio
Retrospective Studies
Ultrasonography

Figure

  • Fig. 1 Distribution of US-guided 14-gauge core-needle biopsies based on lesion size (A), BI-RADS category (B), and pathologic results (C) from 2005 to 2016. BI-RADS = Breast Imaging-Reporting and Data System, DCIS = ductal carcinoma in situ, US = ultrasonography

  • Fig. 2 Line plot and trend lines for proportion of pathologic results. Linear lines (estimated by linear regression) show significant decrease in proportion of benign (A) lesions and significant increase in proportions of high-risk (B) and DCIS (C) lesions over time but no significant trend in proportion of invasive cancer (D) lesions.

  • Fig. 3 Line plot and trend line for total malignancy rate based on BI-RADS category. Linear lines (estimated by linear regression) show that total malignancy rates increased significantly over time in BI-RADS categories 4a (p = 0.020), 4b (p < 0.001), and 4c (p = 0.002) but not in BI-RADS category 3 (p = 0.324) or 5 (p = 0.175).


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