US-guided core needle biopsy of the breast: technique and pitfalls.

Abstract

When core needle biopsy of the breast is performed with ultrasound (US) guidance, the curvature of the breast is used to advantage. The breast is entered from the periphery; this approach allows one to avoid chest wall injury and improves needle visualization. Bringing the needle to the lesion by using a sweeping motion while keeping the transducer position relatively fixed will expedite the biopsy. Standard techniques are modified for evaluation of difficult lesions. Mobile lesions can be fixed with the palm of the operator's hand. Deep lesions can be lifted away from the chest wall with the tip of the needle. For lesions in large breasts, a steeper angle of approach may be necessary but can be matched with the transducer to improve needle visualization. Careful correlation with the mammogram will ensure that the corresponding sonographic abnormality is sampled. Although complications are uncommon, hematoma or infection may occur after the procedure. With practice, application of standard and modffied techniques can result in efficient and accurate US-guided core needle biopsy of the breast. Abbreviation: BI-RADS Breast Imaging Reporting and Data System Index terms: Breast, biopsy. 0(). 1261 #{149} Breast neoplasms, diagnosis. (X).3() #{149} Ultrasound (US). guidance. 00.12985

First experience with a new dedicated ultrasound system for computer-guided large-core breast biopsy

“…In our 45 lesions we achieved no false-negative case; thus, the results of this new system are comparable to other USguided biopsy series with reported sensitivities of 94±100 %, and specificities of 96±98 % [1,4,5,6,7,8]. The question remains as to what other advantages this new dedicated US biopsy system has over conventional US biopsy techniques when the results from all US methods are excellent [1,4,5,6,7,8].…”

“…In the hands of a physician who is experienced with US-guided LCBB either under guidance or freehand technique this new dedicated US biopsy system may have no major impact; however, the non-skilled physician who feels uncomfortable performing US-guided biopsies might benefit from this new system. Impractical equipment handling due to manual intentional synchronization of the transducer and the needle based on eye±hand coordination and good appreciation of three-dimensional relationship are the major problems of conventional US-guided biopsy techniques for unskilled physicians [4,5,6,7,8]. These problems are almost eliminated by the step-by-step biopsy procedure of this new system.…”

Accuracy of sonographically guided 14-gauge core-needle biopsy: Results of 715 consecutive breast biopsies with at least two-year follow-up of benign lesions

“…[19][20][21][22] As in any percutaneous sampling procedure, there are potential pitfalls in CNB. 10 The radiologist performing the sonographically guided CNB should be aware of any technical difficulties that might result in inaccurate sampling. These difficulties include targeting errors secondary to poor lesion or needle visualization, lesion mobility, deep-located lesions, central lesions in a large breast, dense fibrotic tissue resistant to needle traversing, and obscuration of the lesion by hematoma.…”

Differentiation between Pure Mucinous Breast Carcinomas and Fibroadenomas with Strong High-Signal Intensity on T2-Weighted Images from Dynamic Contrast-Enhanced Magnetic Resonance Imaging

“…However, core biopsy specimens of FAs with extreme myxoid change of stroma can be misdiagnosed as MBCs histopathologically [11]. Moreover, breast biopsy is invasive, with risks of complications such as hematoma and infection [12].…”