Underestimation of Ductal Carcinoma In situ on Sonographically Guided Core Needle Biopsy of the Breast.

Jung,  Hye Doo; Lim,  Hyo Soon; Jung,  Se Hee; Jeong,  Su Jin; Seon,  Hyun Ju; Kim,  Jin Woong; Yoon,  Jung Han; Park,  Jin Gyoon; Kang,  Heoung Keun

Journal of Korean Society of Ultrasound in Medicine 2011;30(2): 133-139.

Hye Doo Jung, Hyo Soon Lim, Se Hee Jung, Su Jin Jeong, Hyun Ju Seon, Jin Woong Kim, Jung Han Yoon, Jin Gyoon Park, Heoung Keun Kang

¹Department of Radiology, Chonnam National University Hospital, Korea.
²Department of Radiology, Chonnam National University Hwasun Hospital, Korea. nico1220@dreamwiz.com
³Department of Surgery, Chonnam National University Hwasun Hospital, Korea.

Published online: June 1, 2011.

ABSTRACT

PURPOSE: The purpose of this study was to determine the underestimation rate of ductal carcinoma in situ (DCIS) on sonographically guided 14-gauge core needle biopsy of the breast and to investigate the factors associated with this underestimation. MATERIALS AND METHODS: We retrospectively reviewed 2990 consecutive lesions that underwent sonographically guided 14-gauge core needle biopsy between January 2005 and December 2008. Among them, 61 lesions were pathologically proven to be DCIS (2.04%). A total of 50 DCIS lesions (mean patient age: 50.7 years old, age range: 36-79 years old) that underwent surgical resection were included in this study. After surgery, the lesion proven to be invasive was defined as being in the underestimated group and the lesion proven to DCIS was defined as being in the correctly diagnosed group. We determined the underestimation rate of DCIS and we retrospectively reviewed and compared the clinical, pathologic and radiologic features of the two groups. RESULTS: The underestimation rate of DCIS was found to be 28% (14 of 50 lesions). The underestimation of DCIS was significantly frequent for a clinically palpable lesion (78.6% (11/14) vs. 30.5% (11/36), respectively, p = 0.002). The sonographically maximal diameter of a lesion was significantly larger in the underestimated group than that in the accurately diagnosed group (28.4 +/- 14.0 mm vs. 17.6 +/- 10.3 mm, respectively, p = 0.017) and underestimation was significantly frequent when the sonographic lesion size was > 20 mm (p = 0.012). There was no significant difference in terms of age, the lesion type, the Breast Imaging-Reporting and Data System (BI-RADS) category or the pathologic features between the two groups. CONCLUSION: The underestimation rate of DCIS was 28% for sonographically guided 14-gauge core needle biopsy of the breast. Clinical symptoms such as a palpable lesion and a sonographic lesion size > 20 mm were the factors related with the underestimation of DCIS.

Keywords: Biopsies, technology; Breast, biopsy; Breast, US; Breast neoplasm, diagnosis