Stereotaxic core biopsy of breast carcinoma: accuracy at predicting invasion.

Abstract

Stereotaxic core biopsy of breast carcinoma can help confirm invasion with high accuracy but cannot reliably indicate the absence of tumor invasion when only DCIS is found.

Validity of needle core biopsy in the histological characterisation of mammary lesions

“…This is the result not only of several years of study and work involving preclinical breast lesions, but also of extremely fruitful multidisciplinary cooperation in our Institute between radiologists, surgeons and pathologists. This fact concurs with recently published reports on the same subject by several other authors [1][2][3][4][5] and, furthermore, emphasises the fact that, in the last few years, experience with the use of CB has led to an increase in the diagnosis of ICs using this procedure, compared with the results published a few years ago, 3,6,8,10 when the rates of diagnosis of breast carcinomas using CB ranged from 8% to 42%.…”

“…1 Several published reports have demonstrated that in a high percentage of cases the histological results of CB concur with those obtained from the examination of the whole of the excised specimen. [3][4][5][6][7][8][9] Furthermore, CB provides an extremely high level of diagnostic reliability, not only with regard to cases of infiltrating carcinoma, but also to those involving atypical hyperplasia, lobular carcinomas in situ, [10][11][12][13][14][15][16] (DCIS) 4,5,8,11,14,16,17 and to a large number of benign breast diseases. 18,19 Although CB has not completely replaced traditional excisional biopsy, it is considered to be a valid diagnostic procedure, since it is not only efficient but also well tolerated and not particularly invasive, making it possible for the surgeon to provide the patient with a great deal of information regarding her disease and to plan a more specific therapeutic approach.…”

Stereotactic core-needle biopsy of the breast: a report of the Joint Task Force of the American College of Radiology, American College of Surgeons, and College of American Pathologists

“…Finally, CNB can characterize lesions more completely. [13][14][15][16] Imaging-guided CNB can be performed under stereotactic mammographic or ultrasonographic guidance. The method chosen to guide the biopsy depends on which modality best depicts the abnormality, the location of the abnormality within the breast, and the operator's experience.…”

“…38 Other problems with stereotactically guided CNB include the variability of results with the type of lesion being targeted, lack of standardized definitions and methods for study design, failure to identify invasion in approximately 20% of cases with a CNB diagnosis of ductal carcinoma in situ, and concern about displacement of epithelium and seeding of the needle track with tumor cells. 15,22,36,37,39,40 Cost-effectiveness issues have also been addressed in publications on stereotactically guided CNB of the breast. One article reported that a 50% reduction in the costs of biopsies for nonpalpable breast abnormalities had been achieved by the incorporation of stereotactically guided CNB into the authors' practice.…”

Diagnostic strategies in non-palpable breast lesions

“…Ultrasonography is available in every hospital, but the main disadvantage of sonographic guidance is that the lesion must be sonographically evident to undergo ultrasound-guided biopsy. Thus, ultrasound-guided diagnostic interventions may not be feasible for calcifications and small solid masses that are sonographically not visible [7]. The choice between the different diagnostic strategies, image-guided diagnostic intervention or NLBB is made depending on the image characteristics (including ultrasound), availability of equipment and experienced personnel.…”