EXCISING THE REEXCISION - STEREOTACTIC CORE-NEEDLE BIOPSY DECREASES NEED FOR REEXCISION OF BREAST-CANCER

There is debate regarding use of the stereotactic core-needle biopsy ( SCNB) for highly suspicious mammographic lesions. This study compares a serial group of mammography-detected breast cancer patients treated before and after the use of SCNB. We studied 113 consecutive nonpalpab le breast cancers between 1994 and 1996. Altogether 47 patients were d iagnosed by wire-localized breast biopsy (wire group) and the next 66 consecutive breast cancer patients by SCNB (stereo group). Negative ma rgins were found more often in the stereo group than in the wire group (77% vs. 38%, p < 0.001). Reexcision was required more frequently in the wire group than in the stereo group (68% vs. 21%, p < 0.001), and one-staged surgical procedures were done more often in the stereo grou p than the wire group (79% vs. 21%, p < 0.001). The volume of the init ial wide excision was much larger in the stereo group than in the wire group (p = 0.002). Those in the wire group required 50% more operatio ns per patient (1.8 vs. 1.2) than the stereo group. A significant cost savings can be estimated in the stereo group compared with the wire g roup. The use of SCNB was associated with breast excisions of larger v olume, negative margins, and decreased need for reexcision. Simultaneo us adjunct procedures resulted in one-stage operations, improving cost savings. The use of SCNB for nonpalpable breast cancer benefits the p atient, the surgeon, and the payor. It should be undertaken prior to t he first surgical procedure.