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“The needle’s through the lesion!”:  A reliable sign when considering concordance between imaging and histology?
EP33172
Poster Title: “The needle’s through the lesion!”: A reliable sign when considering concordance between imaging and histology?
Submitted on 17 Oct 2020
Author(s): Anita Bolina 1 , Neil Upadhyay 2
Affiliations: 1 Imperial College London, 2 Imperial College Healthcare NHS Trust
This poster was presented at BIR Annual Congress 2020
Poster Views: 436
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Poster Information
Abstract: BACKGROUND:
Ultrasound-guided core needle biopsy (UG-CNB) is widely used for diagnosing breast pathologies. European guidelines emphasise the importance of documenting needle placement (NP) through the lesion to maximise sample reliability. This study explores the association of NP documentation and a concordant sample on histology.

METHODS:
A retrospective review of MDT outcomes from August 2018 to August 2019 was undertaken at a large breast imaging unit. Imaging and histology for patients requiring a repeat UG-CNB, where there was concern about discordance between histology and imaging, were reviewed using the Cerner© Patient Administration System and Carestream© PACS.

RESULTS:
Of 1812 patients who had a biopsy reviewed at MDT, 51 patients required repeat UG-CNB and had available histology reports. 8 (16%) of these patients had no documentation of NP through the lesion on initial biopsy. Of patients with initial NP documentation, 36 (84%) had concordant diagnoses on initial and repeat biopsy. 3 cases (7%) were upgraded from benign to malignant, 3 cases (7%) changed from non-diagnostic to benign, and 1 case (2%) changed from non-diagnostic to malignant.

CONCLUSIONS:
In a considerable number of cases where ultrasound images on an initial biopsy demonstrated the core biopsy needle through the lesion, the diagnosis changed on repeat biopsy. A new malignant diagnosis was given in 9% of cases. The results of this study suggest that when judging if a repeat biopsy is required at MDT, caution should be taken not to place too much weighting on imaging documentation of a needle through a lesion.
Summary: A retrospective study exploring the role of needle placement in ultrasound guided core needle biopsy in patients requiring repeat breast biopsies. Report abuse »
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