LARGE-NEEDLE CORE BIOPSY - NONMALIGNANT BREAST ABNORMALITIES EVALUATED WITH SURGICAL EXCISION OR REPEAT CORE BIOPSY

PURPOSE: To classify lesions initially considered nonmalignant at larg e-needle core biopsy that were subsequently surgically excised or samp led at repeat biopsy. MATERIALS AND METHODS: From August 1, 1991, to D ecember 31, 1996, 1,032 breast abnormalities (214 malignant and 818 no nmalignant lesions) were sampled at large-needle core biopsy. Of the n onmalignant lesions, 112 (14%) abnormalities were studied. Twenty-four abnormalities:were subsequently excised because of discordant imaging -and pathologic findings; 41 may have been missed at biopsy (25 were s urgically excised, and 16 were sampled at repeat biopsy); 40 were surg ically excised as recommended by the pathologist; and seven were excis ed for other indications. RESULTS: None of 24 abnormalities excised be cause of discordant findings was malignant. Among the 41 possibly miss ed lesions, infiltrating ductal carcinoma was found in one lesion that was removed surgically and in one sampled at repeat biopsy. Among the 40 lesions recommended for excision by the pathologist, 16 malignanci es were found (ductal carcinoma in situ, 11; infiltrating ductal carci noma, three; phyllodes tumor, two). None of the remaining seven lesion s was malignant. CONCLUSION: Correlation of the technical quality of t he biopsy, imaging features and pathologic findings resulted in 96 sur gical excisions and 16 repeat biopsies of lesions initially considered nonmalignant: Eighteen additional malignancies were identified.