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

Abstract

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.

Vacuum-assisted breast biopsy on digital stereotaxic table of nonpalpable lesions non-recognisable by ultrasonography

“…That implies a variation on predictive values between breast radiology units and even between radiologists. Criteria such as imaging evolution in consecutive checks or family risk should be considered [12,35]. Consequently, although follow-up is still the chosen procedure for BI-RADS-3 NPLs, perhaps in the future this behaviour may in some cases be changed due to the implementation of stereotaxic VAPB.…”

“…It can provide a specific diagnosis of both benign and malignant NPLs, including their in situ or invasive condition [9,10,11,12,13,14,15]. This technique is much more accurate on nodules than on distortions, asymmetric densities and calcifications [16,17], lesions that normally are not recognisable by US, so that their reliable diagnosis must be made by stereotaxy.…”

“…This technique is much more accurate on nodules than on distortions, asymmetric densities and calcifications [16,17], lesions that normally are not recognisable by US, so that their reliable diagnosis must be made by stereotaxy. At least five to ten passes are necessary, each one requiring a new insertion of the needle [9,12,16]. The sensitivity in this type of NPL does not exceed 90%; that is why DSB may frequently be necessary [18,19].…”

Comparison of Stereotactic Fine Needle Aspiration Cytology and Core Needle Biopsy in 522 Non-Palpable Breast Lesions

“…This is in line with other investigators. S‐CNB proved to provide a more accurate diagnosis than S‐FNAC in non‐ palpable breast lesions (1). According to A ndreu et al (1) the necessity for surgical diagnostic operations was also reduced.…”

Ductal Carcinoma In Situ and Atypical Ductal Hyperplasia of the Breast Diagnosed at Stereotactic Core Biopsy

“…Stereotactic core needle biopsy (SCNB) has been demonstrated to be an accurate, cost‐effective method of diagnosing breast disease and has been advocated as an alternative to excisional, diagnostic surgical biopsy, particularly in nonpalpable breast lesions (1–4). The difficulty of effectively diagnosing atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) with SCNB has recently been emphasized.…”