PERCUTANEOUS LARGE-CORE BREAST BIOPSY

Background. Surgical excision biopsy is considered by many to be the ' 'gold standard'' for the diagnosis of breast lesions. Fine needle aspi ration biopsy is used by some radiologists and other physicians in an attempt to diagnose breast lesions nonsurgically. To overcome the draw backs associated with both of these methods, the author and his cowork ers have developed the image-guided automated large-core breast biopsy method. Methods. All biopsies are performed using either a dedicated, prone stereotactic device or high-resolution near-field ultrasound eq uipment for needle guidance. A ''long-throw'' (2.3 cm) automated core biopsy device fitted with a 14-gauge needle is used to acquire five or more core samples from each lesion for histologic evaluation. Results . The ability of percutaneous, image-guided, large-core breast biopsy to provide the correct histologic diagnosis of a breast lesion is equi valent to open surgical biopsy. The cost of large-core breast biopsy i s one half to one quarter that of surgical biopsy. No adverse cosmesis or mammographic pseudolesion results. Conclusion. In an era of increa sing cost restraints in health care, it is important to identify means by which the level of patient care can be maintained or improved at l esser cost. Percutaneous large-core breast biopsy provides that opport unity in the diagnosis of breast disease and should prove to be a cost -effective, reliable, and expedient alternative to surgical biopsy.