Preoperative localization of clinically occult breast lesions: experience at a referral hospital.

Meyer, Jack E.; Sonnenfeld, M R; Greenes, Robert A.; Stomper, Paul C.

doi:10.1148/radiology.169.3.2847232

Cited by 29 publications

(9 citation statements)

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“…the rates of malignant lesions in surgical excisions up to 60 -80% compared with 5-20% by using mammography alone and 20 -40% by combining mammography with ultrasound. [1][2][3][4] This represents an improvement in the utilization of surgical management and reduced morbidity for mammographically screened women. More important than reducing surgical rates for benign disease, however, is clinical confidence in a benign diagnosis.…”

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confidence: 99%

A prospective comparison of stereotaxic fine‐needle aspiration versus stereotaxic core needle biopsy for the diagnosis of mammographic abnormalities

Symmans

Weg²,

Gross³

et al. 1999

Cancer

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SFNA identified benign lesions more reliably for follow-up, particularly microcalcifications. Based on these results, the authors suggest 1) added SCBX if on-site SFNA assessment is nondiagnostic, atypical, or positive (and needs preoperative confirmation of invasion); 2) either SCBX or SFNA for masses, architectural distortions, and ill-defined densities; 3) SFNA for microcalcifications, with SCBX added for moderately and highly suspicious lesions; and 4) surgical excision for all highly suspicious microcalcifications.

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mentioning

confidence: 99%

A prospective comparison of stereotaxic fine‐needle aspiration versus stereotaxic core needle biopsy for the diagnosis of mammographic abnormalities

Symmans

Weg²,

Gross³

et al. 1999

Cancer

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“…Surgical biopsy is currently the most widely accepted source of anatomopathological diagnosis [12]. However, surgical removal is expensive, it leaves scars that can interfere with follow-up radiological examinations, and it can also ± though rarely ± be ineffective.…”

Section: Discussionmentioning

confidence: 99%

The impact of stereotactic large-core needle biopsy in the treatment of patients with nonpalpable breast lesions: a study of diagnostic accuracy in 510 consecutive cases

et al. 1998

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The objective of this study was to assess the usefulness of stereotactic large-core needle biopsy (LCNB) in the management of nonpalpable breast lesions (NBL) and compare it with stereotactic fine-needle aspiration biopsy (SFNA) performed simultaneously in a significant number of cases. From November 1993 through June 1997, 510 consecutive patients with NBL underwent 14-gauge LCNB with 354 women undergoing simultaneous 21-gauge SFNA in the same lesson. Mammographic findings lesion size, number of core biopsy specimens, complications and diagnoses of both techniques were analysed. Surgical biopsy, tumorectomy or mastectomy was indicated for malignancy or poor correlation between SFNA or LCNB results and clinical or radiological findings. Values of diagnostic accuracy of both LCNB and SFNA were determined. The ratio benign surgical biopsies/malignant surgical biopsies (BB/CB) of the series was calculated. A total of 171 patients underwent surgical treatment: in 31 (18.1%) a benign process or atypical ductal hyperplasia was the final diagnosis. The ratio BB/CB was 0.22. Sensitivity and specificity were 93.2 and 100%, respectively, for LCNB, and 77.2 and 92.3%, respectively, for SFNA with cytological analysis. Large-core needle biopsy provides more accurate diagnosis than SFNA in the management of nonpalpable breast lesions and obviates a surgical diagnostic procedure in a significant number of cases.

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“…CYTOPATHOLOGIST: STEREOTAXIC BREAST BIOPSY Diagnostic Cytopathology, Vol 24,No 4 patients are immobilized in an uncomfortable position, and many become less cooperative after time (30 min). After the needle is placed, another pair of digital views is obtained to confirm that the needle tip is in the target in both views.…”

Section: How Are Stereotaxic Localization and Biopsy Performed?mentioning

confidence: 99%

“…C: The calcification has refractile, crystalline edges that can be appreciated by using polarization microscopy.CYTOPATHOLOGIST: STEREOTAXIC BREAST BIOPSY Diagnostic Cytopathology,Vol 24,No 4 C: The calcification has refractile, crystalline edges that can be appreciated by using polarization microscopy.CYTOPATHOLOGIST: STEREOTAXIC BREAST BIOPSY Diagnostic Cytopathology,Vol 24,No 4 …”

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What is the role of cytopathologists in stereotaxic needle biopsy diagnosis of nonpalpable mammographic abnormalities?

Symmans

Cangiarella

Gottlieb

et al. 2001

Diagnostic Cytopathology

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The popularity of screening mammography has led to increased detection of mammographic lesions that require pathologic diagnosis. Stereotaxic needle biopsy techniques to sample such lesions can be used to either identify those lesions that require excision from those that can be followed, or to confirm a mammographic impression of malignancy prior to excision. Stereotaxic core biopsy (SCBX) and stereotaxic fine needle aspiration (SFNA) have rarely been directly compared. For this review we undertook a uniform re-analysis of the data that was presented in the published studies of SFNA and/or SCBX. The main endpoint was the negative predictive value (NPV) that measures the frequency that a benign diagnosis is truly benign. There was variability in NPV (likely due to sampling methods) and specific aspects of sampling techniques are discussed. The NPV was compared to indicators of selection of lesions to biopsy (frequency of invasive cancer in the study population), mammographic characteristics (masses or microcalcifications), and the reported nondiagnostic rates. The general conclusion is that SFNA and SCBX are equivalent in accuracy, with considerable variability that reflects the types of lesions that are selected for biopsy and the thoroughness of sampling. For SFNA studies, nondiagnostic rates were inversely related to NPV, and therefore have clinical implications. This was not shown for SCBX studies, and probably reflects an inability to correctly identify non-representative tissue biopsies. The main advantage for including cytologic methods with stereotaxic breast biopsy is immediate sample assessment, and this advantage can also be applied to core needle procedures.

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Preoperative localization of clinically occult breast lesions: experience at a referral hospital.

Cited by 29 publications

References 0 publications

A prospective comparison of stereotaxic fine‐needle aspiration versus stereotaxic core needle biopsy for the diagnosis of mammographic abnormalities

A prospective comparison of stereotaxic fine‐needle aspiration versus stereotaxic core needle biopsy for the diagnosis of mammographic abnormalities

The impact of stereotactic large-core needle biopsy in the treatment of patients with nonpalpable breast lesions: a study of diagnostic accuracy in 510 consecutive cases

What is the role of cytopathologists in stereotaxic needle biopsy diagnosis of nonpalpable mammographic abnormalities?

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