US-guided Core-Needle Biopsy of the Breast: How Many Specimens Are Necessary?

Fishman, Joel E.; Milikowski, Clara; Ramsinghani, Rajeev; Velásquez, María Victoria; Aviram, Galit

doi:10.1148/radiol.2263011622

Cited by 132 publications

(88 citation statements)

References 8 publications

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“…Besides lesions that could undoubtedly be classified as benign or malignant, there is a fraction (termed histological underestimates) of histological findings allowing only an incomplete characterisation of the pathology. In this study, the LNCBbased diagnoses of the 11 DCIS (58%) underestimates for which subsequent analysis of the surgical specimen revealed invasiveness were higher than in other studies (Fishman et al, 2003;Philpotts et al, 2003;Pijnappel et al, 2004). Obviously, there is a certain small risk of misdiagnosing a DCIS lesion to be an ADH, or malignant lesions to consist only of ADH or LCIS (two in our study) on the basis of small samples, which indicates the need for an open surgical approach in ADH and DCIS-classified cases.…”

Section: Discussioncontrasting

confidence: 76%

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Ultrasound-guided large-core needle biopsies of breast lesions: analysis of 962 cases to determine the number of samples for reliable tumour classification

et al. 2004

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The objective of this one-institutional study was to determine the number of large-core needle biopsies (LCNB), under threedimensional ultrasound (3D-US) validation, that are sufficient to obtain a reliable histological diagnosis of a sonographically detectable breast lesion. Over an 28-month period, 962 sonographically guided LCNB were performed under 3D-US validation to assess 962 breast lesions. All biopsies were carried out with an automated core biopsy device fitted with 14-gauge (22 mm excursion) needles. Data of 962 biopsied breast lesions were gathered. Surgical follow-up was available for 659 lesions. Breast malignancies were diagnosed by ultrasound-guided LCNB with a sensitivity of 98.2% by performing three cores per lesion. In few cases, the open surgical specimen revealed the presence of invasive carcinomas in contrast to initial LNCB-based classification as ductal carcinomas in situ (DCIS, 11 lesions), lobular carcinoma in situ (one lesion), and atypical ductal hyperpasia (one lesion). Owing to disagreement between classification based on breast-imaging and histological findings, eight of these tumours were subsequently excised. Of the lesions that were removed at the patients' requests despite benign LCNB diagnosis, two were infiltrating carcinoma and one a DCIS. We demonstrate that three 3D-US-guided percutaneous core specimens are sufficient to achieve tissue for a reliable histological assessment of sonographically detectable breast lesions and allow the detection of malignancies with high sensitivity and low rate of false-negative diagnoses.

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Section: Discussioncontrasting

confidence: 76%

“…However, previously published studies lack consistent data indicating how many biopsies are necessary to achieve a reliable histological finding. There is only one study on a small number of 73 breast lesions that pays attention to that question (Fishman et al, 2003). This investigation consisted of 14 malignant and 59 benign lesions.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided large-core needle biopsies of breast lesions: analysis of 962 cases to determine the number of samples for reliable tumour classification

et al. 2004

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“…3 The importance of core biopsy numbers in determining HG also has been evaluated by McIlhenny et al, 4 and they proposed making at least 4 biopsy passes to obtain a diagnostic accuracy of around 80%. In this study, the mean number of core biopsies was 5.1, and the concordance rate was 100% for histologic type and 80.8% for HG.…”

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The accuracy of preoperative core biopsy in determining histologic grade, hormone receptors, and human epidermal growth factor receptor 2 status in invasive breast cancer

Park

Kim

Lee

et al. 2009

The American Journal of Surgery

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“…With large-core needle biopsy, actual tissue samples are obtained by means of a large-core needle (generally 14-gauge) and an automated biopsy gun. A minimum of four samples is needed, and for lesions containing microcalcifications, specimen radiography is essential in verifying the adequacy of sampling [10,11].…”

Section: Tissue Sampling Techniquesmentioning

confidence: 99%

“…In this review, we give an overview of minimally invasive approaches for the diagnostic and therapeutic management of early-stage breast cancer. The Oncologist 2007;12: [1][2][3][4][5][6][7][8][9][10] …”

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confidence: 99%

Minimally Invasive Approaches for Diagnosis and Treatment of Early-Stage Breast Cancer

Vlastos

Verkooijen

2007

The Oncologist

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LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Describe the minimally invasive approaches to breast cancer diagnosis and treatment.2. List the strengths and weaknesses of minimally invasive diagnostic and treatment procedures.3. Select appropriate patients for minimally invasive approaches to breast cancer diagnosis and treatment.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTBreast cancer management has been evolving toward minimally invasive approaches. Image-guided percutaneous biopsy techniques provide accurate histologic diagnosis without the need for surgical biopsy. Breast conservation therapy has become the treatment standard for earlystage breast cancer. Sentinel lymph node biopsy is a new procedure that can predict axillary lymph node status without the need of axillary lymph node dissection. The next challenge is to treat primary tumors without surgery. For this purpose, several new minimally invasive procedures, including radiofrequency ablation, interstitial laser ablation, focused ultrasound ablation, and cryotherapy, are currently under development and may offer effective tumor management and provide treatment options that are psychologically and cosmetically more acceptable to the patients than are traditional surgical therapies. In this review, we give an overview of minimally invasive approaches for the diagnostic and therapeutic management of early-stage breast cancer. The Oncologist 2007;12: [1][2][3][4][5][6][7][8][9][10]

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US-guided Core-Needle Biopsy of the Breast: How Many Specimens Are Necessary?

Abstract: A minimum of four specimens, preferably those that are nonfragmented and that sink, should be obtained with 14-gauge US-guided breast biopsy.

Cited by 132 publications

References 8 publications

Ultrasound-guided large-core needle biopsies of breast lesions: analysis of 962 cases to determine the number of samples for reliable tumour classification

Ultrasound-guided large-core needle biopsies of breast lesions: analysis of 962 cases to determine the number of samples for reliable tumour classification

The accuracy of preoperative core biopsy in determining histologic grade, hormone receptors, and human epidermal growth factor receptor 2 status in invasive breast cancer

Minimally Invasive Approaches for Diagnosis and Treatment of Early-Stage Breast Cancer

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