Extent of Lumpectomy for Breast Cancer After Diagnosis by Stereotactic Core Versus Wire Localization Biopsy

Abstract

Diagnosis by stereotactic core biopsies resulted in less tissue removal to achieve margin-negative lumpectomies for breast conservation. Stereotactic core biopsy is the method of choice for biopsying nonpalpable, suspicious breast lesions.

Is Stereotactic Large-Core Needle Biopsy Beneficial Prior to Surgical Treatment in BI-RADS 5 Lesions?

“…In our series where all patients first underwent SLCNB, we found that 23% of the local excision specimens (36/159) contained dubious or positive surgical margins. While some authors have reported lower rates of positive surgical margins at surgical excision after a core biopsy diagnosis (0-29%) compared with diagnostic surgical excision biopsy [21][22][23] others have found margin positivity rates to be similar between the two diagnostic methods [24,25]. For BI-RADS 5 lesions, these rates have not been reported thusfar.…”

A Comparison of Ink-Directed and Traditional Whole-Cavity Re-Excision for Breast Lumpectomy Specimens With Positive Margins

“…13,21 When patients present with nonpalpable, mammographically detectable lesions and undergo diagnostic needle localized lumpectomies, positive margins are found in 55% to 89% of the specimens. 12,20,[22][23][24][25] If a diagnosis of malignancy is made by core biopsy, followed by a needle localized therapeutic lumpectomy, several studies have shown that the incidence of positive margins can be decreased. For example, 0 of 7 patients, 22 2 of 19 patients (11%), 25 and 16 of 56 patients (29%) 23 had positive margins when a therapeutic needle localized lumpectomy was performed.…”

“…12,20,[22][23][24][25] If a diagnosis of malignancy is made by core biopsy, followed by a needle localized therapeutic lumpectomy, several studies have shown that the incidence of positive margins can be decreased. For example, 0 of 7 patients, 22 2 of 19 patients (11%), 25 and 16 of 56 patients (29%) 23 had positive margins when a therapeutic needle localized lumpectomy was performed. In analysis of the subgroup of patients in this study with invasive cancer treated at Dartmouth, we also found that the incidence of positive margins on the initial lumpectomy was lower if a diagnosis was known before the lumpectomy.…”

Radioguided occult lesion localization (ROLL) versus wire‐guided lumpectomy for non‐palpable breast lesions: A randomized prospective evaluation

“…With the increase in the number and availability of breast screening programs, detection of breast nonpalpable lesions have increased [2,3]. Traditionally, surgical biopsy of this kind of lesions is carried out with wire localization (WL), being the gold standard during the last decade [4,5]. This technique is used as a diagnostic and therapeutic tool, although with some restrictions during its application.…”