Value of Core Needle Biopsy as the First Diagnostic Procedure in the Palpable Breast Masses

Background: Breast core needle biopsy (CNB) provides enough tissue for histopathologic diagnosis and is considered a reliable method for establishing preoperative tissue diagnosis. The purpose of this study is to evaluate CNB as the first diagnostic step instead of excisional biopsy in palpable breast masses. Materials and Methods: In this prospective study, patients with palpable breast mass who underwent CNB were enrolled. Based on pathology report, patients with malignant lesions revealed by CNB were immediately candidate for surgery and those who had benign lesions were followed up to 3 years. Results: 112 females with palpable breast mass were enrolled in the study. In 103 (91.9%) of cases first attempt CNB provided adequate sample tissue. CNB detected malignant lesion in seventy eight (69.6%) patients. All (100%) malignant CNB reports were confirmed at surgery specimen pathology. In 34 (30.4%) patients CNB revealed benign lesion. At the end of 3 years follow up period, 25 (73%) of these patients underwent open biopsy leading to the detection of 1 (3%) malignant tumor. Overall, according to the gold standard defined as positive surgical biopsy or positive follow-up, sensitivity of CNB was calculated as 98.7% (95% CI, 94.1-100%) and its accuracy was 99.1% (95% CI, 97.4-100%). The specificity of the CNB procedure was 100%. Conclusion: These findings suggest that the malignancy detection power provided by CNB may be weighed equal to that of open biopsy. Therefore, we propose CNB as the first choice in diagnostic evaluation of palpable breast mass especially for those in accessible sites and in experienced hands.