Diagnostic Accuracy for Breast Lump by Core Biopsy without Image Guidance

Open Access

Abstract

Introduction: Breast lumps are a common clinical presentation, and accurate tissue diagnosis is essential for appropriate management. Core needle biopsy (CNB) is widely accepted as a reliable diagnostic tool; however, in resource-limited settings, biopsies are often performed without image guidance for palpable lesions. Aim of the Study: To evaluate the diagnostic accuracy of core biopsy without image guidance in patients presenting with palpable breast lumps. Methods & Materials: This prospective observational study was conducted at Holy Family Red Crescent Medical College & Hospital and Dhaka Cancer and General Hospital Ltd from December 2023 to November 2025. A total of 100 patients with palpable breast lumps underwent unguided core (Tru-Cut) biopsy. Histopathological findings were compared with final diagnoses obtained from surgical excision and/or follow-up. Diagnostic performance parameters were calculated using standard statistical methods. Results: The mean age of patients was 43.22 ± 11.80 years. Malignant lesions accounted for 58% of cases, with invasive ductal carcinoma being the most common. On comparison with the final diagnosis, core biopsy showed 100% sensitivity, 59.2% specificity, 50.0% positive predictive value, 100% negative predictive value, and an overall diagnostic accuracy of 71%. The association between core biopsy results and final diagnosis was statistically significant (p < 0.05). Conclusion: Unguided core biopsy demonstrates excellent sensitivity and negative predictive value for the diagnosis of palpable breast lumps and remains a valuable diagnostic modality in settings where image guidance is unavailable.