Investigation of the concordance between the sonographic and pathologic findings of the ultrasound guided core needle biopsy of breast lesions (with BIRADS 4 or 5 )

Introduction: Core needle biopsy (CNB) provides a relatively large specimen of the tissue that facilitates the accurate pathologic diagnosis. Recognizing the relationship between pathologic and imaging findings is useful for diagnosing malignancy and minimizing invasive procedures .The aim of this study is to investigate the relationship between pathologic and sonographic findings. Materials and Methods: In this retrospective study, 336 patients with BIRADS 4 or 5 sore were selected. These patients were referred to 16 Azar clinic of Tehran University for performing biopsy during 2013-2015. The patients were evaluated in terms of demographic and sonographic haracteristics. All of sonographies performed by one radiologist using a same ultrasound machine and then biopsies performed under ultrasound guide. The specimens were sent to two accredited laboratories for analysis. Pathologic findings were classified into 3 categories according to the ACR 2013 as :benign, malignant and high-risk groups. Sonographic and pathologic findings were recorded in questionnaires. Data were analyzed by descriptive and inferential statistics using SPSS21 software.Results: The mean age of patients was 11.70 ± 42.81 years (82-14). The mean size of tumor was 8.06 ± 16.73 mm (50-5mm).94.3% of patients were classified as BIRADS 4 and 7% of patients were classified as BIRADS 5.In general, benign tumors were observed in 283 patients(84.2%), malignant tumors were observed in 48 patients(14.3%) and high-risk tumors observed in 5 patients(1.5%). 3patients(1.2%) in B4a group and2 patients(6.9%)inB4c group were classified into the high risk group. 19patients (100%) in groupB5, 9patients (20%) in group B4b and 20patients (69%) in group B4c were classified into the malignant group. The major discordancy was in the B4c group with 24.1 % (7 patient) benign ,mostly due to granulomatous mastitis or fet necrosis. There was a significant difference between pathologic diagnosis and BIRADS( P<0.01). Conclusion: This study indicates the importance of using ACR lexicon method in the classification of breast lesions (BIRADS system) and performing biopsy from all B4 and B5 breast lesions.

Keywords:

breast , biopsy , sonography