Author(s)
Edward M. Walton BS
Amy M. Williams PhD
Iyaka J. Awata MD MS
Steven S. Chang MD
Christian E. Keller MD
Affiliation(s)
Wayne State University School of Medicine
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to 1) evaluate the rationale of choosing between FNA and CNB; and 2) weigh the risks and benefits of CNB. Objectives: Ultrasound guided core needle biopsy (CNB) is used to assess liver and breast masses. In the head and neck, fine needle aspiration (FNA) is the standard of care with a reported sensitivity of 89.5% and rate of nondiagnostic aspirates between 3-30%. Despite its higher specificity for malignancy compared to other modalities, CNB is not commonly used in the diagnosis of head and neck masses. Concerns regarding the safety and value of CNB in high risk regions for nerve injury, such as the parotid, have been reported, however have not been robustly studied. Study Design: Retrospective cohort study. Methods: This retrospective study includes 90 patients who underwent salivary gland biopsy. The results of the CNB and FNA results were compared to the pathologic diagnosis of the resection specimen. Results: CNB of salivary gland masses had no complications, similar to FNA. In our cohort of 90 patients, 33 (36%) had FNA and 66 (73%) CNB. Of the 66 CNB, 3 had recurrence of disease; an incidence of 4.5%. Our study had 9 FNA that were later biopsied using CNB prior to removal of the mass. One of these was identified as a malignant neoplasm by FNA, but was later found to be benign. Three of these FNA biopsies were nondiagnostic. The most common diagnosis was pleomorphic adenoma, consistent with the literature. Conclusions: These preliminary results cast doubt on the concerns of complication often associated with CNB. Based on these results, CNB may better predict tumor biology than FNA, with a similar safety profile.