STEREOTAXIC NEEDLE CORE BIOPSY OF BREAST-LESIONS USING A REGULAR MAMMOGRAPHIC TABLE WITH AN ADAPTABLE STEREOTAXIC DEVICE

OBJECTIVE. Fine-needle aspiration and stereotaxic needle core biopsy ( SNCB) are techniques used in the workup of breast lesions suggestive o f cancer. Many surgeons are reluctant to rely on fine needle results, and until now, SNCB could be done only with a dedicated biopsy table. Our study was done to determine whether SNCB could be performed safely and effectively with a regular mammography unit and an added stereota xic device. SUBJECTS AND METHODS. SNCB was performed on 254 patients b y using a Siemens Mammomat 2 regular mammography table with an added s tereotaxic device. Patients were referred from a breast screening cent er, a local tertiary care center, and from our own center. Patients wh o had unequivocal histopathologic evidence of a benign process (133 of 254 patients) did not undergo surgical biopsy and are being followed up mammographically. The remainder(121 patients) all had surgical biop sies. RESULTS. Sufficient material for histologic analysis was obtaine d in 249 (98%) of 254 cases, In 31 of 254 cases, sampling was problema tic. This group comprised cases in which the patient moved within the compression device, the mammographic and histologic diagnoses were dis cordant, or calcifications were not present in the core sample when th e indication for SNCB was the presence of microcalcifications. This gr oup all had open biopsies. In 25 of 254 cases, the pathologic findings were suggestive of cancer. Cancer was detected in 11 of these cases o n open biopsy, Of the 14 benign cases, 11 showed atypical features or ductal hyperplasia on open biopsy. Malignant tumor was diagnosed in 60 of 254 cases by SNCB, Corresponding malignant tumor was seen in 59 of 60 of the open biopsy specimens. CONCLUSION. The SNCB technique is no t limited to use on a dedicated biopsy table but can be readily adapte d to a regular mammography unit. It is a safe, reliable and cost-effec tive procedure that often spares the patient a surgical procedure.