Concordance assay between sonographic and histologic findings in breast lesions under Core Needle Biopsy

Document Type : Original Article


1 Resident, Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associate Professor, Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant Professor, Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Associate Professor, Department of Community Medicine, Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


Introduction: Regarding to high prevalence of breast cancer, it is important to find strategies for early, rapid, convenient and accessible diagnosis. After screening and detecting a lesion in the breast, the type of lesion and the degree of malignancy should be determined.This study was performed with aim to evaluate the concordance between sonographic and histologic findings in breast lesions under core needle biopsy.
Methods: This cross-sectional prospective study was performed on 149 patients referred to Omid Hospital, Mashhad University of Medical Sciences who underwent core needle biopsy from breast lesions during 2015 to 2018. Patients who had BI-RADS 3, 4, and 5 and according to the surgeon's recommendation required biopsy of the lesion underwent ultrasonically guided biopsy. Also, the lesions which had a malignant sonographic view, but were placed in the benign lesions group after core needle biopsy and histologic examination, were evaluated with excision. Data were analyzed using SPSS software (version 22) and descriptive statistics (frequency distribution table and frequency percentage).
Results: The histological findings of BI-RADS 3 lesions were completely benign (11 cases).
The frequency of malignancy in lesions with BI-RADS 4 was 31% (39 cases). All cases with BI-RADS 5 were malignant according to histological finding. 8 (44%) of 18 cases with BI-RADS 4b lesions that were benign according to needle biopsy findings were malignant in excisional biopsy findings.
Conclusion: In cases that breast lesions are BI-RADS 4b in sonography and the results of core needle biopsy showed benign lesions, additional histological diagnostic evaluation is recommended to rule out malignancy. More studies with higher sample sizes are recommended to confirm the results of this study.


  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136(5):E359-86.
  2. Mousavi SM, Montazeri A, Mohagheghi MA, Jarrahi AM, Harirchi I, Najafi M, et al. Breast cancer in Iran: an epidemiological review. Breast J 2007; 13(4):383-91.
  3. Roohparvarzade N. Prevalence of risk factors for breast cancer in women (20 to 69 Years old) in Isfahan 2012-2013. Iran Quart J Breast Dis 2014; 7(1):52-61.
  4. Ghiasvand R, Maram ES, Tahmasebi S, Tabatabaee SH. Risk factors for breast cancer among young women in southern Iran. Int J Cancer 2011; 129(6):1443-9.
  5. Moon HJ, Kim MJ, Yoon JH, Kim EK. Risks of being malignant or high risk and their characteristics in breast lesions 20 mm or larger after benign results on ultrasonography-guided 14-gauge core needle biopsy. Ultrasound Q 2016; 32(2):157-63.
  6. Olver I. Cancer: principles and practice of oncology: annual advances in oncology. Philadelphia: Lippincott Williams & Wilkins; 2012.
  7. Vandromme MJ, Umphrey H, Krontiras H. Image‐guided methods for biopsy of suspicious breast lesions. J Surg Oncol 2011; 103(4):299-305.
  8. Bruening W, Fontanarosa J, Tipton K, Treadwell JR, Launders J, Schoelles K. Systematic review: comparative effectiveness of core-needle and open surgical biopsy to diagnose breast lesions. Ann Intern Med 2010; 152(4):238-46.
  9. Ho CP, Gillis JE, Atkins KA, Harvey JA, Nicholson BT. Interactive case review of radiologic and pathologic findings from breast biopsy: are they concordant? How do I manage the results? Radiographics 2013; 33(4):E149-52.
  10. Liberman L, Drotman M, Morris EA, LaTrenta LR, Abramson AF, Zakowski MF, et al. Imaging-histologic discordance at percutaneous breast biopsy: an indicator of missed cancer. Cancer 2000; 89(12):2538-46.
  11. Mario J, Venkataraman S, Dialani V, Slanetz PJ. Benign breast lesions that mimic cancer: determining radiologic-pathologic concordance. Appl Radiol 2015; 44(9):28-32.
  12. Radhakrishna S, Gayathri A, Chegu D. Needle core biopsy for breast lesions: an audit of 467 needle core biopsies. Indian J Med Paediatr Oncol 2013; 34(4):252-6.
  13. Hille H, Vetter M, Hackelöer BJ. The accuracy of BI-RADS classification of breast ultrasound as a first-line imaging method. Ultraschall Med 2012; 33(2):160-3.
  14. Heinig J, Witteler R, Schmitz R, Kiesel L, Steinhard J. Accuracy of classification of breast ultrasound findings based on criteria used for BI‐RADS. Ultrasound Obstet Gynecol 2008; 32(4):573-8.