Nonpalpable breast lesions: stereotactic automated large-core biopsies.

Abstract

One hundred two patients with mammographically suspicious, nonpalpable lesions underwent stereotactic breast biopsy with a biopsy gun and an automated 14-gauge cutting needle. After biopsy, a localization wire was placed and surgical biopsy performed. There was agreement of the histologic results from the gun biopsy and the surgical biopsy specimens in 98 cases (96%), including 22 of 23 carcinomas (96%) (kappa = 0.936). The gun biopsy yielded findings that led to the correct diagnosis in two cases involving lesions that were missed at surgical biopsy; two lesions found at surgery were missed at gun biopsy. The results of this study suggest that the use of 14-gauge needles improves agreement between surgical and needle core biopsy findings and that stereotactic biopsy with an automated needle and gun can be an acceptable alternative to surgical biopsy in women with mammographically suspicious breast lesions.

Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

“…This value may be overestimated due to the non-blindness of the pathologists (Irwig et al, 1994). In four studies large-core needle biopsy procedures as well as open biopsy procedures were performed on the same day (Parker et al, 1991;Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997). Therefore, pathologists may not have been blinded for the results of the reference standard test (open biopsy).…”

“…Stereotactic biopsy was performed with the patient in prone position by using a 14-gauge needle and a long throw biopsy gun. In four studies all histological diagnoses of large-core needle biopsy specimens were confirmed by additional open biopsy and generally these two procedures took place on the same day (Parker et al, 1991;Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997). In the study of Jackman et al (1999), 295 patients (61%) with a benign diagnosis on large-core needle biopsy did not undergo immediate open biopsy, but mammographic follow-up.…”

“…Twenty-five publications were comments, letters or review articles and in 50 studies, the diagnostic performance of large-core needle biopsy was not the object of study. Of the 43 publications addressing the diagnostic accuracy of large-core needle biopsy, five publications were included in the meta-analysis (Parker et al, 1991;Elvecrog et al, 1993;Gisvold et al, 1994;Pijnappel et al, 1997;Jackman et al, 1999). (A list of the 38 excluded publications and the reasons for exclusion is available upon request.)…”

Magnetic Resonance-Guided Interstitial Laser Photocoagulation for the Treatment of Breast Cancer

“…Mammographically directed stereotaxic biopsy has become a recognized alternative to surgical biopsy for certain cases of breast cancer, with stereotaxic biopsy reliability now approaching that of surgical biopsy [30][31][32]. A variety of prototype stereotaxic devices have been built for MR-directed breast biopsy and needle localization [33][34][35][36][37][38].…”

Spectral-domain low coherence interferometry/optical coherence tomography system for fine needle breast biopsy guidance

“…Therefore, newer techniques and instruments, including stereotactic CT and ultrasound guidance are used for the diagnosis of small nonpalpable breast tumors. [14][15][16][17][18] Unfortunately, these technologies are usually not available in small clinics, require additional personnel, and as a result are less affordable. In this paper we present a technology and instrumentation based on low coherence interferometry for fine needle aspiration breast biopsy guidance.…”