A Comparison Between Core Biopsy and Imaging Techniques (Ultrasound and Mammography) In diagnosis of Breast Cancer in Slemani Breast Center

Abstract = 2231 times | PDF = 500 times

Main Article Content

Taher Abdullah Hawramy Dara Ahmed Mohammed Hasan Abdullah Ahmed


Breast cancer is the global health problem. It is the highest prevalent site-specific cancer in women throughout the world and the most common reason of death in middle age women,  following lung cancer. Up to 5% of breast cancers are caused by inheritance. Male breast cancer accounts for less than 1%. Mammography is the first imaging study to evaluate breast abnormalities, Ultrasound is particularly useful in young women with dense breasts. Core needle biopsy permits the analysis of breast tissue architecture and whether invasive cancer is present. To compare core needle biopsy and imaging, the accuracy of each modality for purpose of the diagnosis and their impact on preoperative planning before surgical treatment. A retrospective cohort study was performed in 70 cases of breast cancer during 2015-2017 at Slemani Breast Center/ Kurdistan region. Inclusion criteria any patient with diagnosed with breast cancer for whom core biopsy and imaging techniques (ultrasound and mammography) were done, Age 25 years and above. Exclusion criteria, a patient with breast mass who did not underwent: one of the two modalities, Age below 25 years, pregnant women. In the current study: mean age/year for the  participants were Mean age = 51.34 year ± 12.85 SD), Sixty-nine cases were female and one male. By core biopsy (97.1%) is positive for malignancy. In this study: results about 34.28% of BIRADS V (ultrasound)lesions proved to be positive for malignancy by core biopsy, 1.43% of BIRADS V were negative for malignancy and the association was statistically highly significant, for BIRADS III lesions 17.14% were proved as positive for malignancy by core biopsy. About 45.7% of BIRADS V (mammography were positive for malignancy by core biopsy and the associations were found to be statistically highly significant and for BIRADS III 12.85% of lesions were positive for malignancy by core biopsy. There was a statistically significant association between radiological investigation(ultrasound, mammography) and histopathological finding (core biopsy).



Breast cancer,Mammography, Ultrasound, and core Biopsy


Download data is not yet available.

Article Details


[1] K. Kelly Hunt, C. Marjorie Green and A. Thomas Buchholz. “Diseases of the Breast”, in Sabiston Textbook of Surgery. The Biological Basis of Modern Surgical Practice, 19th ed. Courtney M. Townsed, R. Daniel Beauchamp, B. Mark Evers, and L. Henneth Mattox, Ed. Philadelphia: Elsevier saunders; 2012 (7):830-833
[2] S. Radhakrishna, Anu Gayathri and Deepa Chegu. “Needle core biopsy for breast lesions”. Indian Journal of Medical and Paediatric oncology, vol.34, pp. 252-256, Dec. 2013
[3] I. Sestak, Jack Cuzick and Gareth Evans. “Breast cancer: Epidemiology, Risk factors and Genetics”, in ABC of Breast diseases, 4th ed. J. Michael Dixon Ed. UK: Wiley-Blackwell, 2012, pp. 41-46.
[4] K. Kelly Hunt, F. John R. Robertson and I. Kirby Bland. “The Breast”, in Schwartz’s, Principles of Surgery. 10th ed. F. Chaerls Brunicardi, K. Dana Andersen, R. Timothy Billiar, L. David Dunn, G. Johun Hunter, B. Jeffery Matthews et al. Ed. USA: MeCraw-Hill; 2015 (17): 497-564.
[5] R. Guo, Guolan Lu, Binjie Qin and Baowei Fei. “Ultrasound imaging technologies for breast cancer detection and management”. Ultrasound in Med. And Bio., vol.44, 1, pp.37-70.
[6] S. Norman Williams, J. Charistopher K. Bulstrode and P. Ronan O’conell. “The Breast” in Short Practice of Surgery, Bailey and Loves. 25th ed. UK: Hodder Arnold; 2008 (50): 828-848. 2017.
[7] G. Loana Andreea, Raluca Pegza, Luana Lascu, Simona Bondari, Zoia Stoica and A. Bondari. “The role of imaging techniques in diagnosis of breast cancer”. Current Health Sciences Journal. vol.37, 2, pp. 55-61. 2011.
[8] A. Jalalian, Syamsiah Mashohor, Rozi Mahmud, Babak Karasfi, M.Iqbal B.Saripan and Abul Rahman B. Ramli. “Foundation and methodologies in computer-aided diagnosis systems for breast cancer detection”, Exceli Journal. vol.16, pp.113-137. Feb.2017.
[9] A. Soyder, Fusun Taskin and Serdar Ozbas. “Imaging-Histological Discordance after Sonographically Guided Percutaneous Breast Core Biopsy”, Breast care; Basel. vol.10 (1): pp.33-37. Feb. 2015.
[10] L. Liberman, F. Andrea Abramson, B. Fredric Squires, R. Jill Glassman, A. Elizabeth Morris, D. David Dershaw. “The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories ”, AJR Am J Roentgenol, USA, vol. 171,(1),pp.35-40. July 1998.
[11] A. Mendez, F. Cabanillas, M. Echeniquem K. Malekshamran, I. Perez and E. Ramos. “Mammographic features and correlation with biopsy findings using 11-gauge stereotactic vacuum-assisted breast biopsy”, Ann. Oncol. vol.15 (3), pp.450-454. Mar. 2004.
[12] S. Andrea Hong, L.Eric Rosen, S. Mary Soo and A. Jay Baker. “BIRADS for sonography: positive and negative values of sonographic features”, AJR, vol. 184, pp.1260-1272. April 2005.
[13] C. Balleyguier, Salma Ayadi, Kim Van Nguyen, Daniel Vanel, Clarisse Dromain and Robert Sigal. “BIRADS classification in mammography”, EJR Elsevier, vol. 61, pp.192-194, 2007.
[14] K. Hukkinen. “Early diagnosis of breast cancer”, https://helda.helsinki.fi/bitstream/handle/10138/22658/earlydia.pdf?sequence=1, pp.1-70. Nov.2017.
[15] L. Samay Singh. “Validity of BI-RADS system mammography in detecting breast cancer at Kenyatta national hospital”, http://hdl.handle.net/11295/95124 , University of Nairobi research archive, pp.1-66, 2015.
[16] A. Redman, Simon Lowes and Lice Leaver. “Imaging techniques in breast cancer”, Elsevier,vol. 34(1), pp. 8-18. Jan., 2016.
[17] O. Graf, H. Thomas Helbich, H. Michael Fuchsjaegar, Gottfried Hopf, Margarita Morgun,Claudia Graf, Reinhold Mallek and A. Edward Sickles. “Follow-up of palpable circumscribed noncalcified solid breast masses at mammography and US: can biopsy be averted?”, RSNA Radiology, vol. 233(3), pp.850-856, 2004.
[18] C. Saladin, Harald Hauseisen, Gerk Kampmann, Christian Oehlschlegel, B. Seifert, Luzi Rageth, Christoph Rageth, S. Stadlmann and A. Rahel Kubik-Huch. “Lesions with unclear malignant potential (B3) after minimally invasive breast biopsy: evaluation of vacuum biopsies performed in Switzerland and recommended further management”, Acta Radiologica, vol. 57(7), pp.815-821,2016.
[19] C. Shashirekha A., R. Rahul Singh, H.Ravikiran R., Krishna Prasad and P. Sreeramulu N. “Fine needle aspiration cytology versus trucut biopsy in the diagnosis of breast cancer A comparative study”, International journal of biomedical research, vol. 8(9),pp.497-500,2017.
[20] F. Mary Dillon, D. Arnold K. Hill, M. Cecil Quinn, O. Ann Doherty, W. Enda McDermott and Naill O’Higgins. “The accuracy of ultrasound, stereotactic, and clinical core biopsies in the diagnosis of breast cancer, with an analysis of false-negative cases”, Annals of surgery, vol. 242(5),pp.701-707,Nov.2005.
[21] J. Hyun Youk, So Jung Kim, Eun Ju Son, Hye Mi Gweon and Jeong-Ah Kim. “Comparison of visual assessment of breast density in BI-RADS 4th and 5th edition with automated volumetric measurement”, AJR, vol. 209(3),pp.703-708,Sep.2017.
[22] O. Kinyuru Daniel, Sung Mook Lim, Joo Heung Kim, Hyung Seok Park, Seho Park and Seung II Kim. “Preoperative prediction of the size of pure ductal carcinoma in situ using three imaging modalities as compared to histopathological size: does magnetic resonance imaging add value?”, Breast Cancer Res Treat, vol.164,pp.437-444,2017
[23] T. Cortadellas, Paula Argacha, Juan Acosta, Jordi Rabasa, Ricardo Peiró, Margarita Gomez, Laura Rodellar, Sandra Gomez, Alejandra Navarro-Golobart, Sonia Sanchez-Mendez, Milagros Martinez-Medina, Mireia Botey, Carlos Muñoz-Ramos and Manel Xiberta. “Estimation of tumor size in breast cancer comparing clinical examination, mammography, ultrasound and MRI—correlation with the pathological analysis of the surgical specimen”, Gland surgery, vol.6(4),pp.330-335,Aug.2017.
[24] M. Baykara, Zeynep Özkan , Yeliz Gül , Özgen Aslan and Leyla Güngör. “Effectiveness of the Triple Test and Its Alternatives for Breast Mass Evaluation”J. Breast Health, vol.9(4),pp.195-199,Oct.2013.
[25] M. Naseem, Joshua Murray, F. John Hilton, Jason Karamchandani, Derek Mura C. dali, Hala Faragalla, Chanele Polenz, Dolly Han, David Bell, and Christine Brezden-Masley. “Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis”, BMC Cancer, vol.15, pp.307-315,April 2015.
[26] R. Steinitz, L. Katz and M. Ben-Hur “ Male breast cancer in Israel: selected epidemiological aspects”, Isr J Med Sci., vol. 17, (9-10), pp.816-21, Oct.1981.
[27] D. Dobromir Dimitrov, P. Martin Karamanliev , S. Tashko Deliyski, Anisla Gabarski , P. Petar Vatov , O. Ruzha Gencheva. Et. Al. “Diagnostic value of tru-cut biopsy in diagnosing breast lesions”, JBCR, vol. 9 (2), pp.126-129, 2016.