Abstract:
Objective To evaluate the diagnostic value of ultrasound-guided core needle biopsy (CNB) and fine needle aspiration (FNA) in the metastatic internal mammary node (IMN) of breast cancers (BCs).
Methods The data of 496 BCs patients who underwent ultrasound-guided IMN biopsy from May 2012 to October 2020 in The Fourth Hospital of Hebei Medical University were retrospectively analyzed. There were 374 cases in CNB group, and 122 cases in FNA group. Consistency kappa test was used to analyze the diagnostic efficacy of CNB and FNA, and the sensitivity and specificity were calculated. The diagnostic efficacy of CNB and FNA in different sizes and types of IMN and the factors influencing specimen satisfaction were analyzed.
Results The rates of unsatisfied specimens in CNB and FNA were 5.6% (21/374) and 3.3% (4/122), respectively (P>0.05). Excluding the unsatisfied specimens, the Kappa values of CNB and FNA were 0.817 and 0.907. Subgroup analysis showed that Kappa values of CNB and FNA were 0.877, 1.000 and 0.772, 0.783 in IMN with thickness <0.5 cm and 0.5-0.9 cm groups, respectively (P<0.01). In IMN with thickness ≥1.0 cm group, the false negative rate of CNB was 3.4% (1/29), and there was no false negative in the FNA group.
Conclusions For the qualitative diagnosis of IMN, FNA had a higher diagnostic efficiency. FNA is also a safer biopsy method because IMN is generally small, with a special location.