Impact of Core Needle Biopsy as the First Diagnostic Procedure in Palpable Breast Masses among Rural Population: Single Institutional Study

Abstract

Background: Among rural populations, where frequent visits to the hospital are not possible, Core needle biopsy (CNB) is considered a reliable investigation for confirming diagnosis preoperatively in palpable Breast lumps. Our study aims to assess CNB as the first reliable diagnostic tool for palpable breast lumps among the rural population. Materials and Methods: This is a prospective cross-sectional study, that included 102 patients with palpable breast masses who had undergone Tru-Cut biopsies. Based on the histopathology report, patients with malignant lesions confirmed by CNB were immediately scheduled for surgery according to their staging. On the other hand, those with benign lesions were followed up for up to three years. The rural population was categorised based on demographic characteristics including domicile, age, size of the tumour, type of tumour, the number of core needle biopsies, and the percentage of inadequate samples. Finally, the accuracy, sensitivity, and specificity of the CNB were determined. Benign, malignant, and unspecified samples obtained by core needle biopsy were evaluated with the samples of the surgical and pathological findings. Results: The study population consists of 102 females with a palpable breast lump. Of the 97 (96.87%) cases CNB provided adequate tissue samples, and malignancy was confirmed in seventy-six (68.6%) patients. In 34 (30.4%) patients CNB turned out to be benign lesions of which only one patient turned out to be positive for malignancy at the end of the 3-year follow-up period. As per the gold standard defined as positive surgical biopsy and follow-up, the sensitivity of CNB was as high as 98.7% (95% CI, 94.1-100%) and diagnostic accuracy was 99.1% (95% CI, 97.4-100%). The specificity of the CNB procedure was 100%. Conclusion: Our findings in a single Institute suggest that the cancer detection rate provided by CNB may be on par with that of open biopsy. Hence, we conclude that CNB is the first choice in the diagnostic evaluation of palpable breast mass among rural populations, as they also provide material for Immunohistochemistry which also aids in planning individualistic management.

Keywords

• core needle biopsy
• palpable lump
• rural women
• breast cancer