Accuracy of Core Needle Biopsies in Diagnosing Breast Malignancies: A Systematic Review.

Abstract

Background: Breast cancer is one of the most common malignancies across the world and a top cause of cancer-associated death in women. The diagnosis needs to be done early and correctly in order to manage and improve patient outcomes. Core needle biopsy (CNB) has become a commonly used minimally invasive method of assessment of the suspicious lesions in the breast among the existing diagnostic methods. Although it has been extensively used, the differences in reported diagnostic accuracy across the studies warranted a review. Objective: The purpose of this systematic review is to evaluate the diagnostic validity of core needle biopsy, in the detection of breast malignancies, in terms of sensitivity, specificity, and general reliability, in various clinical scenarios. Methods: Systematic review was carried out according to Preferred Reporting Items on Systematic Reviews and Meta-Analyses (PRISMA). An extensive review of literature was conducted on PubMed, Scopus, Web of Science, and Google Scholar of articles published between 2010 and 2025. Keywords were core needle biopsy, breast cancer diagnosis, diagnostic accuracy, sensitivity and specificity. Qualified studies were those that involved human research that measured the diagnostic performance of CNB. Data were extracted on the characteristics of the studies, sample size, sensitivity, specificity, and the accuracy of the studies. The QUADAS-2 tool was used to assess quality. Results: The studies incorporated showed a high diagnostic accuracy of CNB, and sensitivity (between 85 and 99 percent) and specificity (approaching 100 percent) were high in the majority of cases. The differences in findings were noticed because of the expertise of the operators, nature of the lesions, imaging guidance method, and needle gauge. In general, CNB demonstrated good reliability in the distinction between benign and malignant lesions in the breast. Conclusion: Core needle biopsy is a very precise diagnostic technique that is effective and accurate in diagnosing malignancies of the breast. It is a low invasive and high diagnostic procedure that is a desirable alternative to surgical biopsy in most clinical settings. Nevertheless, procedural factors and standardization should be paid attention to in order to ensure that the discrepancies of diagnoses are reduced.