Gereç ve Yöntem: Çalışmada meme lezyonlarından ultrasonografi eşliğinde iğne biyopsisi alınan ve histopatolojik değerlendirme yapılan 930 kadın hasta retrospektif olarak incelendi. Yaşları, lezyonlarının histopatolojik tipleri ve malign tümörlerin dereceleri değerlendirildi.

Bulgular: Hastalardan 189’unun (%20.32) histopatolojik tanısı malign tümör, 608’inin (%65.38) tanısı fibrokistik değişiklik, fibroadenom, intraduktal papillom, mastit, yağ nekrozu ve adenozis gibi benign lezyonlarken, 133’ü (%14.30) normal meme dokusu olarak tanı almıştı. Malign tümörlerin %10.58’i; Lobüler, tübüler, müsinöz, medüller ve metaplastik karsinomlar gibi özel tip meme karsinomu iken %89.42’si özel tip içermeyen İnvaziv meme karsinomuydu. Özel tip içermeyen İnvaziv meme karsinomlarının histolojik derecelendirmesi Modifiye Bloom Richardson derecelendirme sistemine göre yapıldı. Derece 1,2,3 tümörlerin oranları sırasıyla %36.09, %52.66 ve %11.25 idi.

Sonuç: Ultrasonografi eşliğinde yapılan iğne biyopsisi, meme kitlesine cerrahi tedavi öncesi hızlı ve kesin tanı verilebilmesi amacıyla uygulanan en uygun yöntemdir. Çünkü minimal invazivdir, memeye estetik olarak hasar vermez ve lezyonun da histopatolojisini bozmaz. Ayrıca bu yöntem Östrojen, progesteron reseptörleri, HER2 ve MIB-1 gibi immünhistokimyasal çalışmaların ilk başta yapılarak, uygun tedavi yaklaşımını, neo-adjuvan tedavi gereksinimini veya uygun cerrahi metodunu saptamak için yeterli doku sağlar.

This Project was evaluated by Research and Publication Ethics Committee with 180092 registration number and 111/2018 decision number and it was approved in terms of scientific researches and patient ethics.

In statistical analysis of data, mean and standard deviation for continuous variables and percentages for categorical variables were used. Descriptive statistics and categorical variables were given as frequencies (percentages).

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Table 1: Histopathological evaluation of the breast core needle biopsies.

The biopsies which were seen as normal breast parenchym were reported as Usual breast tissue. Fibrocystic changes, fibroadenomas, intraductal papillomas, mastitis, fat necrosis and adenosis were taken into the benign category.

The mean age of the malignant tumors was 49.3 (min 30–max 89). Among the malignant tumors 20 cases (10.58%) were diagnosed as special type of invasive carcinoma (lobular, tubular, mucinous, medullary and metaplastic carcinomas). One hundred and sixty nine cases (89.42%) of the malignant tumors were classified as Invasive carcinoma of no special type (NST). Histological grading of the invasive carcinomas of no special type was made according to the Modified Bloom Richardson grading system (Table 2).

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Table 2: The histological grades of the Invasive carcinomas of no special type (NST)

Among the 189 patients with malignant tumors, the diagnoses of 161 (85.19%) were confirmed with the surgical specimens (breast conserving surgery, simple or modified radical mastectomy) that are performed in our hospital; however 28 patients preferred other hospitals for surgery.

In our study we diagnosed normal breast tissues in biopsies of 133 patients. The ratio of this group was similar with the study of Hukkinen et al. ¹⁶. We also join the idea of them and think the foremost reason of this was missing the mass while taking the biopsy with the needle. So the exclusion of a lesion in these patients is impossible with the first biopsy. The correlation of the radiological diagnosis of the breast with the histopathology is needed by subsequent biopsies.

We also observed that most of the lesions (65.38%) were benign. Normally close clinical and radiological follow-up is the optimal approach for them. However most of the patients (71.85%) preferred excision of their benign lesions in order not to live with a breast mass as this was psychologically disturbing and not to visit the hospital frequently and also to eliminate the possibility of presence of carcinoma focus in a benign lesion. These results were in paralel with the study of Koç et al. ⁹ in the literature.

Ultrasonography guided breast core needle biopsy is the most suitable diagnostic approach which is used preoperatively for quick and accurate diagnosis ¹⁷. Because this method is minimal invasive, does not damage the breast aesthetically and the lesion histologically. It provides enough tissue for immunohistological studies like estrogen, progesterone receptors, HER2, MIB-1 which are used to determine the appropriate approach to the malignant tumors, to determine the need for neo-adjuvant theraphy or to decide the surgical method.

As a result, ultrasonography-guided breast core needle biopsy is a quite easy, quick and safe diagnostic approach and the histopathologically correct diagnostic rates are very high.

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