The objective of this study was to examine the diagnostic accuracy of sonographically guided 14‐gauge core‐needle biopsy (CNB).

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.

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%.

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. © 2005 Wiley Periodicals, Inc. J Clin Ultrasound 33:47–52, 2005