Stereotaxic Core-Needle Biopsy in Assessing Intraductal Pathologic Findings at Ductography
G A Belonenko1, N A Sukhina1, A A Aksyonov2
1Donetsk National Medical University, Donetsk, Ukraine.
European Journal of Breast Health
|July 20, 2022
Summary
Ductography (DG) can guide stereotactic core-needle biopsy (sCNB) for breast lesions causing nipple discharge. This method shows promise for preoperative diagnosis, potentially reducing unnecessary surgeries for benign conditions.
Area of Science:
- Radiology
- Oncology
- Surgical Pathology
Background:
- Pathological nipple discharge (PND) necessitates accurate diagnosis of underlying intraductal breast lesions.
- Ductography (DG) is an imaging technique used to visualize the breast ducts.
Purpose of the Study:
- To evaluate the efficacy of ductography (DG) in guiding stereotactic core-needle biopsy (sCNB) for localizing and differentiating benign and malignant intraductal breast proliferations in patients with PND.
Main Methods:
- The study involved 183 patients undergoing various examinations including physical, radiological, ultrasound, endoscopic, and histopathological assessments.
- Ductography (DG) was performed in 51 patients, with endoscopic mammoductoscopy (EMDS) in eight.
- Stereotactic core-needle biopsy (sCNB) under DG guidance was performed in 26 patients.
Main Results:
- Preoperative sCNB under DG guidance correctly identified benign intraductal proliferations (IDP) in 23 of 26 patients, with three cases (11.5%) showing invasive cancer.
- DG demonstrated high sensitivity (87.9%) but low specificity (33.3%) for detecting IDP.
- A false positive rate of 25.9% was observed, often due to peripheral lesion location or incomplete excision.
Conclusions:
- Stereotactic core-needle biopsy (sCNB) guided by ductography (DG) shows promising results for the preoperative histological assessment of intraductal breast lesions.
- Further research is required to confirm if this approach can decrease the rate of open surgeries for benign conditions identified by sCNB.
