Stereotactic breast biopsy with a biopsy gun.

Parker, Steve H.; Lovin, Jeffrey; Jobe, W E; Luethke, James M.; Hopper, Kenneth D.; Yakes, Wayne F.; Burke, Brian J.

doi:10.1148/radiology.176.3.2167501

Cited by 334 publications

(139 citation statements)

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“…- 3 Two open-biopsy specimens were incorrectly diagnosed as DCIS (i.e., expert panel reclassified final histologic diagnosis as benign).- 4 Ten lesions diagnosed as DCIS and 3 diagnosed as invasive cancer on large-core needle biopsy contained only benign or normal breast tissue at excision biopsy. Panel review showed that the needle biopsies of 5 of these lesions (1 invasive and 4 DCIS) were incorrectly diagnosed as malignant by the pathologist.…”

Section: Discussionmentioning

confidence: 99%

“…One of these alternatives is the stereotactic large-core needle biopsy on a prone biopsy table. 3 In the United States, the stereotactic large-core needle biopsy is now generally accepted as an alternative for open-breast biopsy. 4,5 Much has been written about the diagnostic accuracy of this technique, but the number of studies with adequate surgical or clinical follow-up is limited 6 and in several studies patient selection took place.…”

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confidence: 99%

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Diagnostic accuracy of stereotactic large‐core needle biopsy for nonpalpable breast disease: Results of a multicenter prospective study with 95% surgical confirmation

Verkooijen

2002

Intl Journal of Cancer

139

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Stereotactic large-core needle biopsy is increasingly applied for the diagnosis of nonpalpable breast disease. Our study examines whether this minimally invasive technique is sufficiently accurate to replace surgical breast biopsy. In a prospective multicenter study, 973 consecutive women with 1,029 nonpalpable breast lesions were offered stereotactic 14-gauge needle biopsy. If the needle biopsy yielded breast cancer, the patient was offered therapeutic surgery. Surgical biopsy was proposed in cases of needle biopsies without malignancy. An expert panel reviewed all discrepancies in histologic diagnosis between the needle biopsy and open biopsy. Forty-five patients withdrew from participation and 113 (11%) planned needle biopsy procedures were cancelled. Of the 871 successful biopsy procedures, 95% were confirmed surgically. In 13 cases (1.5%), insufficient material was obtained for histologic assessment. Fifty-five percent of the needle biopsies were diagnosed as malignant (290 invasive cancers, 190 ductal carcinoma in situ). Thirteen of the 322 lesions (4%, 95% CI 2-7%) with a benign needle biopsy diagnosis contained malignancy after surgery. Six of the 26 (23%, 95% CI 9 -44%) lesions with a high-risk diagnosis (atypical ductal or lobular hyperplasia or lobular carcinoma in situ) were diagnosed as malignant after surgery. Five of the 30 lesions containing normal breast tissue held malignancy (17%, 95% CI 6 -35%). Guidelines for the management of different categories of needle biopsy diagnoses were made. Application of these guidelines to the present findings resulted in sensitivity and specificity rates of 97% (95% CI 95-98%) and 99% (95% CI 97-100%), respectively. Stereotactic large-core needle biopsy is an accurate diagnostic instrument for nonpalpable breast disease. It may safely replace needle localised open-breast biopsy provided that high-risk and normal breast tissue diagnoses are followed by needle or openbreast biopsy.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Diagnostic accuracy of stereotactic large‐core needle biopsy for nonpalpable breast disease: Results of a multicenter prospective study with 95% surgical confirmation

Verkooijen

2002

Intl Journal of Cancer

139

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“…Previous studies have shown that while CNB is highly reliable and sensitive for distinguishing between malignant and benign disease [1][2][3], it is less reliable for diagnosing atypical ductal hyperplasia (ADH). For patients diagnosed with ADH at CNB, the rate of upgrade to ductal carcinoma in situ or invasive cancer at follow-up surgical excision is reported as 19-87% [4][5][6][7][8][9]. Therefore, follow-up surgical excision is generally recommended when ADH is diagnosed at CNB.…”

Section: Introductionmentioning

confidence: 99%

Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy

Han

Lee

et al. 2007

Breast Cancer Res Treat

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Background The aim of this study was to determine factors that predict under-evaluation of malignancy in patients diagnosed with atypical ductal hyperplasia (ADH) at ultrasound-guided core needle biopsy (CNB), and to develop a prediction algorithm for scoring the possibility of a diagnosis upgrade to malignancy based on clinical, radiological and pathological factors. Methods The study enrolled patients diagnosed with ADH at ultrasound-guided CNB who subsequently underwent surgical excision of the lesion. Multivariate analysis was used to identify relevant clinical, radiological and pathological factors that may predict malignancy. Results A total of 102 patients with ADH at CNB were identified. Of the 74 patients who underwent subsequent surgical excision, 34 (45.8%) were diagnosed with invasive or in situ malignant foci. Multivariate analysis revealed that age [50 years, microcalcification on mammography, size on imaging [15 mm and a palpable lesion were independent predictors of malignancy. Focal ADH was a negative predictor. A scoring system was developed based on logistic regression models and beta coefficients for each variable. The area under the ROC curve was 0.903 (95% CI: 0.82-0.94), and the negative predictive value was 100% for a score B3.5. Similar findings were observed for a validation dataset of 54 patients at other institutions. Conclusions A scoring system to predict malignancy in patients diagnosed with ADH at CNB was developed based on five factors: age, palpable lesion, microcalcification on mammography, size on imaging and focal ADH. This system was able to identify a subset of patients with lesions likely to be benign, indicating that imaging follow-up rather than surgical excision may be appropriate.

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“…Stereotactic coreneedle breast biopsy described by Parker et al [1] is widely used for the evaluation of non-palpable breast lesions. In addition to high sensitivity and specificity in confirming malignant tissue in suspicious breast lesions [2], core samples also allow preoperative determination of histological prognostic factors such as grade, type, and invasion of neoplasm, as well as ER, PR and HER-2 status by immunohistochemistry (IHC) [3Á5].…”

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confidence: 99%

Surgical specimen can be replaced by core samples in assessment of ER, PR and HER-2 for invasive breast cancer

et al. 2008

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Stereotactic breast biopsy with a biopsy gun.

Cited by 334 publications

References 0 publications

Diagnostic accuracy of stereotactic large‐core needle biopsy for nonpalpable breast disease: Results of a multicenter prospective study with 95% surgical confirmation

Diagnostic accuracy of stereotactic large‐core needle biopsy for nonpalpable breast disease: Results of a multicenter prospective study with 95% surgical confirmation

Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy

Surgical specimen can be replaced by core samples in assessment of ER, PR and HER-2 for invasive breast cancer

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