Ultrasound-Guided Core Biopsy of Breast Lesions in a Resource Limited Setting: Initial Experience of a Multidisciplinary Team

Abstract

Objective: There is increasing tendency to multidisciplinary care of patients with of breast lesions. This study sought to evaluate the initial experience of the diagnostic arm of a new breast program in a resource limited setting.Materials and Methods: In 2015, we commenced the pilot phase of an IRB-approved breast care protocol. As part of the protocol’s diagnostic arm, an ultrasound-guided breast core biopsy training was implemented. Eligible patients were clinically evaluated and underwent CNB using 16G needle under US guidance. The procedure was rated by the participants and histopathological results compared with surgical specimens.Results: Eighty six participants (18.22%) with 113 palpable breast lesions completed the study. The diagnostic accuracy, sensitivity, and specificity were 94.44%, 92.86%, and 95.83% respectively. Unweighted kappa- coefficient (k) agreement between histopathology of core biopsy and surgically excised specimens, were 0.798 (95% CI of 0.69 - 0.90) and 0.801 (95% CI of 0.71-0.92) for benign and malignant breast lumps respectively. The procedure was well accepted and all the patients were willing to accept a repeat CNB and would recommend it.Conclusion:Despite the prevailing challenges, co-ordinated team diagnosis is feasible and may result in the modest improvement in the diagnostic accuracy of breast lesions and patient satisfaction.

Keywords

• ultrasound-guided
• core biopsy
• palpable
• breast