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Breast Imaging: Ruey-Feng Chang, Sheng-Fang Huang, Woo Kyung Moon, Yu-Hau Lee, and Dar-Ren Chen Solid Breast Masses: Neural Network Analysis of Vascular Features at Three-dimensional Power Doppler US for Benign or Malignant Classification Radiology 2007; 243: 56-62 [Abstract] [Full text] [PDF]

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Why Replace Percutaneous Needle Biopsy of the Breast with Sophisticated New Imaging Techniques?

Stefano Ciatto, MD   (7 June 2007)

Why Replace Percutaneous Needle Biopsy of the Breast with Sophisticated New Imaging Techniques? 7 June 2007
Stefano Ciatto, MD, radiologist Centro per lo Studio e la Prevenzione Oncologica Send letter to journal: Re: Why Replace Percutaneous Needle Biopsy of the Breast with Sophisticated New Imaging Techniques? s.ciatto{at}cspo.it Stefano Ciatto, MD	Editor: In their report, Dr. Chang and colleagues (1) conclude that “three-dimensional power Doppler US images and neural network analysis of features can aid in classification of breast tumors as benign or malignant.” I respectfully ask who would be aided by such a test. State-of-the-art differential diagnosis of equivocal breast lesions detected at palpation or imaging is currently based on free-hand or US- or stereo-guided core biopsy, which has been commonly reported to be associated with an overall diagnostic accuracy exceeding 90% and a sensitivity exceeding 95%, at a relatively limited cost. What would be the advantage of using an alternative approach with an 85% accuracy and an 83% sensitivity—not to mention the cost of a new technique, which is likely far from being null? The variety of new diagnostic techniques (eg, color or power Doppler US, scintimammography, contrast-enhanced US, elastography) proposed in the last decade as possible surrogates for standard microinvasive tissue diagnosis seems to be prompted by some a priori refusal to use percutaneous needle biopsy that is hard to explain and should be justified by at least having comparable (possibly better) accuracy relative to state-of-the-art methods. Reference 1. Chang R-F, Huang S-F, Moon WK, Lee Y-H, Chen D-R. Solid breast masses: neural network analysis of vascular features at three-dimensional power Doppler US for benign or malignant classification. Radiology 2007;243:56-62.