Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology and Research Institute of Radiological Science, Yonsei Biomedical Research Institute, Seoul, Korea.
Korean J Radiol. 2020 Mar;21(3):259-267. doi: 10.3348/kjr.2019.0695.
To examine time trends in ultrasonography (US)-guided 14-gauge core needle biopsy (CNB) for breast lesions based on the lesion size, Breast Imaging-Reporting and Data System (BI-RADS) category, and pathologic findings.
We retrospectively reviewed consecutive US-guided 14-gauge CNBs performed from January 2005 to December 2016 at our institution. A total of 22,297 breast lesions were included. The total number of biopsies, tumor size (≤ 10 mm to > 40 mm), BI-RADS category (1 to 5), and pathologic findings (benign, high risk, ductal carcinoma [DCIS], invasive cancer) were examined annually, and the malignancy rate was analyzed based on the BI-RADS category.
Both the total number of US scans and US-guided CNBs increased while the proportion of US-guided CNBs to the total number of US scans decreased significantly. The number of biopsies classified based on the tumor size, BI-RADS category, and pathologic findings all increased over time, except for BI-RADS categories 1 or 2 and category 3 (odds ratio [OR] = 0.951 per year, 95% confidence interval [CI]: 0.902, 1.002 and odds ratio = 0.979, 95% CI: 0.970, 0.988, respectively). Both the unadjusted and adjusted total malignancy rates and the DCIS rate increased significantly over time. BI-RADS categories 4a, 4b, and 4c showed a significant increasing trend in the total malignancy rate and DCIS rate.
The malignancy rate in the results of US-guided 14-gauge CNB for breast lesions increased as the total number of biopsies increased from 2005 to 2016. This trend persisted after adjusting for the BI-RADS category.
基于病变大小、乳腺影像报告和数据系统（BI-RADS）分类以及病理结果，研究超声引导 14 号活检针活检（CNB）用于乳腺病变的时间趋势。
我们回顾性分析了 2005 年 1 月至 2016 年 12 月在我院进行的连续超声引导 14 号 CNB。共纳入 22297 个乳腺病变。每年检查活检总数、肿瘤大小（≤10mm 至>40mm）、BI-RADS 分类（1 至 5）和病理结果（良性、高危、导管原位癌[DCIS]、浸润性癌），并根据 BI-RADS 分类分析恶性率。
超声扫描和超声引导 CNB 的总数均增加，而超声引导 CNB 占超声扫描总数的比例显著下降。基于肿瘤大小、BI-RADS 分类和病理结果分类的活检数量均随时间增加，除 BI-RADS 类别 1 或 2 和类别 3（每年的比值比[OR]为 0.951，95%可信区间[CI]为 0.902 至 1.002 和 OR 为 0.979，95%CI 为 0.970 至 0.988）外。未经调整和调整后的总恶性率和 DCIS 率均随时间显著增加。BI-RADS 类别 4a、4b 和 4c 的总恶性率和 DCIS 率呈显著上升趋势。
2005 年至 2016 年，随着活检总数的增加，超声引导 14 号 CNB 对乳腺病变的恶性率增加。在调整 BI-RADS 分类后，这一趋势仍然存在。
