Accuracy of sonographically guided 14-gauge core-needle biopsy: results of 715 consecutive breast biopsies with at least two-year follow-up of benign lesions

PURPOSE: The objective of this study was to examine the diagnostic accuracy of sonographically guided 14-gauge core-needle biopsy (CNB). METHODS: Sonographically guided 14-gauge CNBs of 715 breast lesions were performed in 652 patients. Histopathologic results were correlated with imaging findings, and repeat biopsy was recommended in the cases of discordance between the radiologic and pathologic results. Long-term follow-up was used for patients with CNB findings of a benign lesion. RESULTS: Sonographically guided CNB revealed malignancy in 311 lesions (43%). Thirty-one lesions with CNB findings indicating benign conditions underwent additional image-guided or excisional biopsy because of indeterminate pathologic features, disagreement between radiologic and pathologic results, surgeon preference, or patient request. Within these 31 cases, 9 malignancies were diagnosed. The duration of follow-up for the remaining 373 benign lesions varied from 27 to 60 months. In 3 of these 373 cases, carcinoma was diagnosed at the site of CNB. The false-negative rate of 14-gauge sonographically guided CNB was 3.7%, and the sensitivity of sonographically guided CNB for the diagnosis of breast cancer was 96.3%. CONCLUSIONS: Sonographically guided 14-gauge CNB is a safe and accurate method for evaluating breast lesions that require tissue sampling. Radiologic-pathologic correlation and follow-up of benign lesions are essential for a successful breast biopsy program.     

Metastasis of primitive neuroectodermal tumor to the breast

We performed mammography and sonography on a 49-year-old woman who had a mass in her left axilla that had been present for 1 month and who had undergone excision of a primitive neuroectodermal tumor (PNET) on her back 1 year before. Mammography revealed 2 adjacent, dense nodules in the left breast and enlarged lymph nodes, without a fatty hilum or internal microcalcifications, in the left axilla. Sonography showed 2 round to oval, markedly hypoechoic nodules in the left breast and enlarged, markedly hypoechoic lymph nodes, without microcalcifications, in the left axilla. We then performed sonographically guided core biopsy. Histopathologic analysis of the specimens confirmed the presence of PNET in the left breast and axillary lymph nodes. The patient was then treated with chemotherapy. To our knowledge, this report is the first to describe radiologic findings of metastasis of PNET to the breast.     

Development of a self-efficacy scale for mammography

Mammography screening has been demonstrated to decrease mortality from breast cancer. Although adherence rates have increased, there is still a need to increase annual screening. Self-efficacy is a construct that has been found useful in predicting behaviors. Measurement of self-efficacy needs to be specific to the behavior and to have good validity and reliability. The purpose of this study is to describe development of a self-efficacy instrument to measure confidence in obtaining a mammogram. Bandura's model guided item development. Construct validity was measured using confirmatory factor analysis and logistic regression. Cronbach alpha was used to test internal consistency reliability. A Cronbach alpha coefficient of .87 was obtained. The mammography self-efficacy scale evidenced content and construct validity.     

Feeding outcomes and influences within the neonatal unit

This study examined the feeding intention of mothers (n = 100), and the factors and beliefs, and changes in those factors or beliefs that influenced their choices, in the challenging environment of the neonatal unit. Mothers' experience and the frequency of nurse-assisted feeding activities were examined in mothers intending and not intending to breast-feed on discharge. Eighty-one per cent of mothers were either partially or fully breast-feeding or intending to do so on discharge. The most important factors identified as influencing this feeding choice included personal choice, with other influences being special benefits, more natural and feeling closer to the baby. Experiences such as infants receiving their first sucking feed from either the breast or bottle (inclusive of breast milk) and mothers expressing breast milk more frequently, were found to be significantly different and increased in frequency, in mothers intending to breast-feed. Differences in the mean weighted total daily nurse-assisted feeding score confirmed that these activities varied with gestational age (< or = 32 weeks [2.57], 32 to less than 35 weeks [3.86], and > or = 35 weeks [4.91]; F = 7.04, d.f. 55, P = 0.002), although there was insufficient power to determine differences between breast-feeding and non-breast-feeding mothers. The use of the Feeding Activities Calendar may have contributed to increased activity and high levels of breast-feeding in this preterm group.