STEREOTAXIC CORE NEEDLE-BIOPSY OF MAMMOGRAPHIC BREAST-LESIONS AS A VIABLE ALTERNATIVE TO SURGICAL BIOPSY

Background: Stereotactic needle biopsy technique has received consider able attention as a possible alternative to surgical biopsy of nonpalp able breast lesions. The exact role of this procedure in the managemen t of mammographic breast lesions has not yet been accurately defined. Methods: Data have been collected prospectively on 416 patients over a n 8-month period (January 1992 through August 1992). Of 416, 356 patie nts underwent only stereotactic breast biopsy with a 14-gauge needle. Sixty patients underwent stereotactic breast biopsy followed by surgic al biopsy. Based on mammographic findings before biopsy, lesions were classified as benign (24%), likely benign (49%), malignant (2%), likel y malignant (6%), and indeterminate (19%). The number of core biopsy s pecimens obtained from each patient ranged from one to six. Results: T he specimen was considered adequate in 98% of cases. Complications wer e minimal. The tissue diagnosis was benign in 92% and malignant in 8% of patients. In those patients undergoing surgical and stereotactic bi opsy, 57 of 60 had matching histopathological results, representing an agreement rate of 95% (p < 0.001). The three patients whose histopath ological results did not match had malignant diagnoses on stereotactic biopsy that were subsequently not identified in the modified radical mastectomy specimen because the entire focus of malignancy was removed by the several passes made by the core needle during biopsy. No patie nt had a negative stereotactic biopsy result in whom malignancy was la ter detected by surgical biopsy. Conclusions: This study indicates exc ellent agreement between surgical and stereotactic needle biopsy findi ngs. Stereotactic biopsy with a 14-gauge needle could obviate the need for surgical biopsy in certain women with radiologically benign, like ly benign, and indeterminate lesions.