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

Bassett, Lawrence W.; Winchester, David P.; Caplan, Robert B.; Dershaw, D. David; Dowlatshahi, Kambiz; Evans, W. Phil; Fajardo, Laurie L.; Fitzgibbons, Patrick L.; Henson, Donald E.; Hutter, R. V. P.; Morrow, Monica; Paquelet, Jean R.; Singletary, S. Eva; Curry, John J.; Wilcox-Buchalla, Pam; Zinninger, M.

doi:10.3322/canjclin.47.3.171

Cited by 136 publications

(30 citation statements)

References 63 publications

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“…The study radiologist used the Breast Imaging Reporting and Data System (BI-RADS) lexicon to assign each mammographic abnormality a level of suspicion with respect to the harboring of malignant disease. 26 Core biopsy was performed using stereotactic or sonographic guidance. Stereotactic biopsy was performed using a directional, vacuum-assisted biopsy device (Mammotome; Biopsy/Ethicon Endo-Surgery, Cincinnati, OH) with an 11-gauge needle in 97 (91%) of 106 cases.…”

Section: Review Of Imaging Studiesmentioning

confidence: 99%

Lobular neoplasia on core‐needle biopsy—Clinical significance

Arpino

Allred

Mohsin

et al. 2004

Cancer

109

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Section: Review Of Imaging Studiesmentioning

confidence: 99%

Lobular neoplasia on core‐needle biopsy—Clinical significance

Arpino

Allred

Mohsin

et al. 2004

Cancer

109

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“…All malignant findings on percutaneous biopsy were considered true-positive findings. 5 Benign percutaneous pathologic findings confirmed by subsequent surgical or long-term stable imaging follow-up were considered true-negative findings. Questionable or benign percutaneous findings found to be malignant at surgical excision or imaging follow-up were considered false-negative findings.…”

Section: A B Cmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10] In this procedure, biopsies of questionable masses are done under either stereotactic or ultrasonographic guidance. In stereotactically guided large-core needle breast biopsy, a computer accurately determines the position of the needle within the breast lesion with 2 radiographs taken at -15°and +15°off the 0°axis.…”

mentioning

confidence: 99%

Fourteen‐gauge ultrasonographically guided large‐core needle biopsy of breast masses.

Schoonjans

Brem

2001

J of Ultrasound Medicine

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Objective. Large-core needle biopsy of the breast can be performed with stereotactic or ultrasonographic guidance. However, ultrasonographically guided large-core needle biopsy has notable advantages, including the absence of ionizing radiation, increased patient comfort, and greater cost-effectiveness. The purpose of this study was to evaluate the accuracy of ultrasonographically guided large-core needle biopsy for the diagnosis of breast cancer in palpable and nonpalpable breast masses. Methods. The study was a retrospective review of consecutive ultrasonographically guided large-core needle biopsies for indeterminate breast masses. A total 424 ultrasonographically guided core biopsies were performed in 367 patients with 1 or more breast masses. Ultrasonographically guided core biopsy was performed with a 14-gauge spring-loaded needle and a freehand technique. Correlation of ultrasonographically guided core biopsy pathologic findings with subsequent surgical pathologic findings or long-term imaging followup was performed. Results. Of 424 indeterminate breast lesions for which histopathologic findings were obtained by ultrasonographically guided core biopsy, 234 cancers were diagnosed. Twenty-eight additional lesions had either questionable but not definitively malignant pathologic features (n = 11) or radiologic-pathologic discordance (n = 17) and were surgically excised. Of these, 8 additional cancers were diagnosed. Patients or surgeons chose excision of 41 additional lesions that were benign on ultrasonographically guided core biopsy. No cancer was found in these surgical specimens. One additional cancer was diagnosed at a 6-month imaging follow-up because of interval growth. On the basis of surgical and long-term imaging follow-up, the sensitivity of ultrasonographically guided core biopsy for the diagnosis of breast carcinoma was 99.2% (95% confidence interval, 95.6%-99.9%) in 173 palpable breast masses and 93.2% (95% confidence interval, 87.1%-97%) in 251 nonpalpable masses. In cancers diagnosed on the basis of immediate surgical excision as a result of ultrasonographically guided core biopsy that showed either questionable pathologic features or radiologic-pathologic discordance, the sensitivity of ultrasonographically guided core biopsy for the diagnosis of breast cancer was 99.2%. Conclusions. Ultrasonographically guided large-core needle biopsy is a sensitive percutaneous biopsy method for the diagnosis of breast cancer in palpable and nonpalpable breast masses.

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“…The Joint Task Force of the American College of Radiology, the American College of Surgeons, and the College of American Pathologists recommends that the presence of microcalcifications in SCNB must be confirmed microscopically with deeper levels beyond initial sections being examined if necessary (7). Intuitively, it is the role of the pathologist to identify in the tissue sample the histologic correlate of the clinical finding that prompted the biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Radiography of the paraffin block has been recommended as a way of determining whether calcifications remain in unsectioned tissue (7). In our own experience, interpretation of radiographs of paraffin-embedded tissue is much more difficult for SCNB than for NLB, and uncertainty in the interpretation has led us to abandon this step and proceed directly to complete sectioning.…”

Section: Discussionmentioning

confidence: 99%

Does Exhaustive Search for Microcalcifications Improve Diagnostic Yield in Stereotactic Core Needle Breast Biopsies?

2001

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Stereotactic core needle biopsy (SCNB) of the breast is a cost-effective alternative to needle localization biopsy for the diagnosis of mammographic calcifications. We questioned whether an exhaustive search for calcium in the small samples obtained in SCNB yields more diagnostic information than that obtained with examination of a standard number of sections. We retrospectively reviewed 168 specimens from 123 patients with mammographic calcifications, including cases in which radiographic suspicion ranged from low to high. Microcalcifications were identified on three initial levels in 112 specimens. Additional sections were examined in 50 specimens. The final diagnosis differed from the diagnosis based on three levels in 11/50 cases (22%). In 6/50 (12%), complete sectioning yielded a specific diagnosis. The increase in technical cost associated with the additional levels was 414% per case. We conclude that exhaustive searching for microcalcifications in SCNB yields a small increase in specific diagnostic information and a high technical cost. In individual cases, the additional information may be critical for appropriate patient management.

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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

Cited by 136 publications

References 63 publications

Lobular neoplasia on core‐needle biopsy—Clinical significance

Lobular neoplasia on core‐needle biopsy—Clinical significance

Fourteen‐gauge ultrasonographically guided large‐core needle biopsy of breast masses.

Does Exhaustive Search for Microcalcifications Improve Diagnostic Yield in Stereotactic Core Needle Breast Biopsies?

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