Stereotactic Breast Biopsy

Abstract

Summary B ecause most of the lesions detected during screening are impalpable, subsequent needle biopsy must be image-guided. lesions better seen on mammography images, particularly microcalcifications, require stereotactic localization. stereotactic breast biopsy performed with large-core needles can accurately diagnose most breast pathologies, often allowing a diagnosis to be made more quickly and less expensively than with surgical biopsy. For benign lesions, establishing a definitive diagnosis obviates unnecessary surgical excision and allow protracted follow-up. Major complications, such as hemorrhage and infection, are extremely rare, although post-biopsy ecchymosis and tenderness are not unusual. Because less tissue is removed, post-biopsy cosmetic deformity does not occur. Stereotactic core biopsy has a reported accuracy of at least 90%. All lesions for which biopsy would ordinarily be recommended are amenable to stereotactic techniques. Calcifications tend to occur in areas of DCIS and/or adjacent benign tissue and because stereotactic core biopsy specifically targets calcifications,so stereotactic core biopsy performed with the 11-gauge vacuum assisted device was reliable for diagnosis of DCIS as was open surgical biopsy.Vacuum assisted Stereotactic (mammo-graphic) biopsy is used primarily for microcalcifications and for masses not visible with ultrasound. Minimally invasive biopsy should be a standard practice in the non-operative diagnosis of breast lesions that are suspicious for or highly suggestive of malignancy. Image-guided biopsy is recommended for almost all cases of suspected breast cancer (BI-RADS 4-5), whether or not the patient is symptomatic or the lesion palpable. Vacuum assisted ultrasound-guided biopsy allows real-time imaging, can be performed without breast compression. Vacuum assisted MRI-guided biopsy is used for suspicious areas of contrast enhancement that cannot be seen on ultrasound or mammography.