Core breast biopsy, research, and what not to do.

Burbank, Fred; Belville, J S

doi:10.1148/radiology.185.3.1438738

Cited by 15 publications

(4 citation statements)

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“…However, the results of our study for diagnosing non-palpable solid breast lesions using US 18-gauge CNB show a diagnostic accuracy comparable to that noted in studies in which 14-gauge needles were used. A suggestion supported by our findings is that lesions in which mammography reveals the presence of microcalcifications frequently consist of friable and fatty tissue (12,21,22), both of which are believed to be responsible for incorrect diagnosis with smaller needles (12,21). We found that was much higher than in earlier reports, and that sensitivity was as high as when larger needles were used.…”

Section: Discussionsupporting

confidence: 82%

The Reliability of Ultrasound-guided Core Needle Biopsy in the Evaluation of Non-palpable Solid Breast Lesions Using 18-gauge Needles

Lim

Kim

Sneige

2003

J Korean Radiol Soc

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Purpose: Ultrasound-guided core needle biopsy (US CNB) is increasingly used in the histologic evaluation of non-palpable solid breast lesions. We retrospectively investigated the diagnostic accuracy of this technique, using an 18-gauge needle in 422 nonpalpable breast lesions. Materials and Methods: 583 female patients with an average age of 56 (range, 22 90) years underwent 590 US CNBs. Between January 1994 and December 1999, using 18-gauge needles, an average of four cores per lesion was obtained. Three hundred and eighty-five lesions were subsequently surgically excised; for 14 of these, the pathologic diagnosis was breast carcinoma metastasis, while 23 with benign diagnoses were clinically followed up for 2.5 years and were considered for analysis. Results: Of the 422 lesions, 340 (80.6%) were malignant [308 invasive, 24 ductal carcinoma in situ (DCIS), 7 DCIS with undetermined invasion and 1 DCIS vs. lobular carcinoma in situ], 67 (15.9%) were benign [30 fibroadenoma (FA) and 37 other diagnoses], and five (1.2%) were fibroepithelial lesions. The remaining ten samples (2.4%) included six cases of atypical ductal hyperplasia (ADH), two of atypical hyperplasia (AH), and two of lobular neoplasia. The sensitivity, specificity, positive predictive value, and negative predictive value of CNBs were 99%, 100%, 100%, and 96%, respectively. Two cases of invasive carcinoma were missed at CNB; there was no false-positive diagnosis. Five of six ADHs and one of two AHs were found to be carcinomas (3 DCIS and 3 infiltrating duct carcinomas). Sixteen of 24 (66.7%) cases of DCIS were found at excision to be invasive carcinomas. Of 31 FAs, two (6.5%) were found to be low-grade phyllodes tumor (PT). The five fibroepithelial lesions were shown at excision to be either PT (n=4) or FA (n=1). Conclusion: US CNB using an 18-gauge needle is a safe and reliable means of diagnosing breast carcinoma. Because of the high prevalence of ductal carcinoma in these lesions; findings of ADH/AH at US CNB indicate that surgical excision is needed. In order to rule out low-grade PT, a diagnosis of FA at CNB requires close follow-up.

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Section: Discussionsupporting

confidence: 82%

The Reliability of Ultrasound-guided Core Needle Biopsy in the Evaluation of Non-palpable Solid Breast Lesions Using 18-gauge Needles

Lim

Kim

Sneige

2003

J Korean Radiol Soc

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“…Thus, even support ers of 14-gauge needles in breast core biopsy would welcome a prospective comparative study of different needle sizes [18].…”

Section: Conclusion Ourresults Indicate That Thequantity Andquality mentioning

confidence: 99%

“…tissue,areaswith microcalcifications on mam mography frequently consist offriable and fatty tissue [1,18,26,29]. Both friable and fatty tis sueare believedto be responsiblefor an incor rect diagnosis with smaller needles [1].…”

Section: It Hasbeen Suggested Thatasinbenign Breastmentioning

confidence: 99%

Evaluation of needle size for breast biopsy: comparison of 14-, 16-, and 18-gauge biopsy needles.

Helbich¹,

Rudas²,

Haitel³

et al. 1998

American Journal of Roentgenology

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OBJECTIVE. Thepurpose ofourstudy wastocompare thequantity andquality oftissueharvested from breast biopsy when using 14-, 16-, and 18-gauge â€oe¿ long-throwâ€• needles. SUBJECTS AND METHODS.Weperformed aprospective randomized study in64patients with 66 breast lesions. Under stereotactic guidance, passes were made in random order with each of the three biopsy needles in each lesion. Samples were measured for tissue area and scored for their quality. All lesions, including benign and malignant lesions and lesions with and without microcalcifications, were analyzed. Findings of the biopsy samples were compared with the final diagnoses made at surgical excision.

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“…The sensitivity of stereotactic core biopsy is reported to range from 71 to 100%, and the latest studies indicate that stereotactic core biopsy will soon replace localization and excisional biopsy (9,10). Factors affecting the accuracy of diagnosis are biopsy needle size, the presence of microcalcifications rather than lumps, the number of cores, and the presence of atypical ductal hyperplasia (11–14). In addition, ABBI may not be used for all lesions, especially for small lesions (less than 5 mm), for it renders conservative breast surgery difficult since the lesion becomes virtually invisible.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Utility of ABBIR (Advanced Breast Biopsy Instrumentation) for Nonpalpable Breast Lesions in Korea

2000

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Introduction of mammography along with particular attention for the diagnosis and treatment of nonpalpable breast lesions has led to the development of nonresectional biopsies such as mammography-guided core needle biopsy, ultrasound-guided fine needle aspiration cytology, and localization and excisional biopsy. The Advanced Breast Biopsy Instrumentation (ABBI(R)) system, a recently developed device, has made it possible to remove a lesion completely under local anesthesia, thus providing a more reliable and rapid evaluation on an outpatient basis. We studied 159 patients with nonpalpable breast lesions from December 1996 to August 1998. Fifty-nine patients received core needle biopsies and 100 patients received excision with the ABBI system. The ABBI system patients had postexcisional mammography and specimen radiographs to confirm complete excision of the lesions. Pathologists examined permanent section specimens. In cases of malignancy, total mastectomy or reexcision was performed to secure a tumor-free margin. We collected malignant lesions in 23 of 159 patients, of whom 17 had ductal carcinoma in situ (DCIS). Postoperative histopathologic reports showed DCIS in 11 and infiltrating ductal carcinoma (IDC) in 2 among the 13 malignancies proven by stereotactic core biopsy. Among 10 malignancies proven by the ABBI system, there were 6 DCIS, 1 lobular carcinoma in situ (LCIS), and 3 IDC. In seven patients in whom mammography suggested malignancy but core biopsy showed benign lesion, localization and excisional biopsy confirmed DCIS in four of seven patients. The ABBI system is a more reliable and rapid method of evaluating breast lesions compared with stereotactic core biopsy. It is usually done under local anesthesia, minimizing the deformity of the breast. Therefore the ABBI system can be used as a preferred technique over conventional localization and excisional biopsy.

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Core breast biopsy, research, and what not to do.

Cited by 15 publications

References 0 publications

The Reliability of Ultrasound-guided Core Needle Biopsy in the Evaluation of Non-palpable Solid Breast Lesions Using 18-gauge Needles

The Reliability of Ultrasound-guided Core Needle Biopsy in the Evaluation of Non-palpable Solid Breast Lesions Using 18-gauge Needles

Evaluation of needle size for breast biopsy: comparison of 14-, 16-, and 18-gauge biopsy needles.

Diagnostic Utility of ABBIR (Advanced Breast Biopsy Instrumentation) for Nonpalpable Breast Lesions in Korea

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