Dr. Lubna Waheed, Dr. Aqsa Khalid, Dr. Rabia Batool
Aim: To evaluate the effectiveness of USG guided core needle biopsy (US-CNB) as a preoperative diagnostic method of breast cancer. Study Design and duration: This prospective cross-sectional study was held on 93 patients with ultrasound detection of breast lumps at the Department of Pathology and Surgery department of Bahawal Victoria Hospital (BVH) Bahawalpur for one-year duration from June 2019 to June 2020. Patients: Methods: A total of 93 women with solid and / or indirect changes in the breasts visualized on ultrasound were included. Apart from clinical treatment, all the above-mentioned patients underwent US-guided core-needle biopsy and excision of the lesions in the breasts. Then, the histopathological diagnosis of US guided core needle biopsy was compared with the results of excision biopsy. Results: Of all 93 cases, 47 (50.5%) had mild ultrasound changes; In US-CNB, 24 were found as fibroadenoma, four with chronic inflammatory mastitis, five with chronic purulent mastitis, one tuberculosis, four fat necroses, two mammary adenomas, and seven cases with benign ductal hyperplasia without atypia. Nine (9.7%) cases showed suspected abnormalities in ultrasound examination; US-CNB revealed five cases with atypical ductal hyperplasia, one ductal carcinoma in situ, and three invasive ductal carcinomas. Thirty-seven (39.8%) cases were highly indicative of malignancy on ultrasound; US-CNB showed 34 invasive ductal carcinomas, two invasive lobular and one medullary. Excision biopsy confirmed the diagnosis of US guided core needle biopsy in all but four cases; one case of chronic purulent mastitis was diagnosed as tuberculosis, and three cases of ductal hyperplasia as invasive ductal carcinoma. Consequently, there was no false positive but four (4.3%) false negatives. Thus, the sensitivity of the US-CNB was 100% and the specificity was 91.1%. Conclusion: USG guided core needle biopsy is a satisfactory method of histopathological diagnosis of breast changes. An open biopsy should be performed after any unsatisfactory, suspicious, or unusual change in the US-CNB. Keywords: breast ultrasound, core biopsy, breast cancer.