STEREOTAXIC CORE BIOPSY OF IMPALPABLE SPICULATED BREAST MASSES

OBJECTIVE. The role of stereotaxic core biopsy in evaluating mammograp hically detected lesions that have a high probability of being maligna nt is still debated, This study was undertaken to assess the use of st ereotaxic core biopsy in evaluating spiculated masses, by determining the frequency with which core biopsy reduced the number of surgical pr ocedures performed in the management of these highly suspicious lesion s. MATERIALS AND METHODS. Forty-three impalpable spiculated breast mas ses in 43 patients were sampled with stereotaxic core biopsy, All pati ents underwent surgery. Patient charts were reviewed to determine the histopathologic findings at stereotaxic core biopsy and at surgery, an d the number and type of surgeries performed. RESULTS. Invasive carcin oma was identified at stereotaxic core biopsy in 40 (93%) of 43 patien ts. Therapeutic surgical procedures were lumpectomy in 28 patients (22 with axillary dissection) and mastectomy in 12. The presence of tumor at the lumpectomy margins led to subsequent mastectomy in one case. O ne lesion yielded atypical ductal hyperplasia at core biopsy; surgical biopsy revealed ductal carcinoma in situ. Surgical biopsy was recomme nded in two lesions yielding benign histologies at core biopsy and rev ealed invasive ductal carcinoma in one. Thirty-three (77%) of 43 patie nts had the number of surgical procedures reduced by stereotaxic core biopsy; these were patients with carcinoma diagnosed at core biopsy wh o underwent one-stage lumpectomy with axillary lymph node dissection o r mastectomy. CONCLUSION. Stereotaxic core biopsy reduced the number o f surgical procedures in most women with impalpable spiculated breast masses. These data suggest that stereotaxic core biopsy is a valuable diagnostic technique for assessing these lesions, which are likely to represent carcinoma.