EVALUATION OF NONPALPABLE SOLID BREAST MASSES WITH STEREOTAXIC LARGE-NEEDLE CORE BIOPSY USING A DEDICATED UNIT

OBJECTIVE. In our institution for the past ii years, stereotaxic core breast biopsy using a 14-gauge needle has been offered as an alternati ve to surgical excision. The purpose of this paper is to describe our protocol, results, and lessons learned from our experience. MATERIALS AND METHODS. From August 1991 to July 1995, 388 stereotaxic needle cor e biopsies of clinically occult, noncalcified, mammographically detect ed solid masses were performed, In this group, 103 patients underwent subsequent surgical excision. Another 169 have had follow-up examinati ons 1 year or more after their biopsies. RESULTS. Of the 61 patients d iagnosed with a malignant process on core biopsy, all had confirmation on subsequent surgical excision. Forty-one of the 42 core biopsies th at showed a benign process were subsequently confirmed on surgical exc ision, One patient with atypical ductal hyperplasia on core biopsy had ductal carcinoma in situ on surgical excision, Patients with 169 beni gn masses on core biopsy have been followed for at least 1 year by mam mography, Of these women, 110 have been followed for at least 2 years, and no malignant lesions have been found. CONCLUSION. Stereotaxic lar ge-needle core biopsy appears to be an accurate alternative to surgica l excision for evaluating a solid breast mass, However, the mammograph ic appearance, technical quality of the biopsy, and pathologic finding s in each patient must be correlated to ensure the highest possible ac curacy when using this technique.