J Korean Soc Ultrasound Med.  2011 Jun;30(2):133-139.

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

• Jung HD
• Lim HS
• Jung SH
• Jeong SJ
• Seon HJ
• Kim JW
• Yoon JH
• Park JG
• Kang HK

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.

Keyword

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

MeSH Terms

Biopsy, Large-Core Needle
Breast
Carcinoma, Ductal
Carcinoma, Intraductal, Noninfiltrating
Humans
Information Systems
Retrospective Studies