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The diagnostic utility of ultrasound-guided core needle biopsy in breast lumps
Breast cancer is the most common site-specific cancer in women and is a leading cause of death from cancer in women aged 20–59 years. There have been a number of studies evaluating the role of the ultrasound-guided core needle biopsy in the management of breast lumps; however, there is lack of such studies in the United Arab Emirates. The aim of this study is to determine the sensitivity and specificity of core needle biopsy in detecting breast malignancy. The study was carried out between December 2009 and December 2012. Adult female patients who underwent ultrasound-guided core needle biopsy (CNB) for breast lumps at surgical departments (Dubai Hospital and Rashid Hospital) followed by surgical excision of that lump were included in the study. Patients aged <13 years, males and those who did not undergo an operation were excluded. The total number of CNBs performed was 245, but only 79 cases fulfilled the inclusion criteria. Histological results of CNB were compared with the histological results of surgically excised specimens. Out of 79 CNBs performed there were 47 malignant specimens, 28 benign specimens and four classified as ‘possible’. CNB showed a sensitivity of 84.9% [95% confidence interval (CI) 72.4% to 93.23%] and specificity of 90.9% (95% CI 70.80% to 98.62%). Positive and negative predictive values were 95.75% and 71.43, respectively. The results of CNB showed medium sensitivity in diagnosing breast cancer in this study, which is below international figures. Non-standardization of the procedure and less experienced junior doctors are the main contributing factors to this lower sensitivity. CNB should be properly planned and performed by a trained specialist who has reasonable ultrasound skills, or by a radiologist.
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