The study, the largest ever to review real-time ultrasound and biopsy using a 14-gauge needle, found that the 14-gauge needle is more than 99% accurate in diagnosing breast cancer, says Richard Chesbrough, MD, senior staff physician at Henry Ford Hospital in Detroit.
As part of the study, 700 patients, who had suspicious masses found on ultrasound, had a biopsy with a 14-gauge automated tru-cut needle. An average of five core samples was taken from each lesion biopsied. The results indicated that there were 196 cancers; 193 cancers were proven at subsequent surgical pathology, says Dr. Chesbrough. “The three discordant lesions were subsequently proven to be other types of cancer or a tiny focus of ductal carcinoma in situ on careful radiology-pathology correlation. The patients received appropriate treatment,” notes Dr. Chesbrough.
In addition, the 14-gauge needle biopsies indicated that 504 of the suspicious masses were benign. Follow-up radiology-pathology correlation revealed that nine of these diagnoses were discordant with imaging findings. These patients underwent further surgical excision of their lesions. The remaining patients with benign results have been followed for at least two years. To date, none of these patients has developed cancer at the site of the original lesion, he says.
“Many physicians are wondering if there is a need to use a larger 8, 11 or 12-gauge needles in order to get enough tissue for an accurate breast diagnosis. This study shows us that less is really more,” says Dr. Chesbrough. Patients “don’t have to sacrifice accuracy by having a less invasive biopsy when you have the ability to see the biopsy performed under real-time ultrasound,” says Dr. Chesbrough. “The less invasive 14-gauge needle biopsy clearly sets the standard of care, ” he says.
The cost of the 14-gauge needle is about one-tenth the cost of the larger needles, he says. It is readily available, and a biopsy using this needle takes significantly less time than a biopsy using larger needles and vacuum systems, he says.
Dr. Chesbrough will present the study on May 5 during the American Roentgen Ray Society Annual Meeting in San Diego.
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