THE IMPACT OF STEREOTACTIC LARGE-CORE NEEDLE-BIOPSY IN THE TREATMENT OF PATIENTS WITH NONPALPABLE BREAST-LESIONS - A STUDY OF DIAGNOSTIC-ACCURACY IN 510 CONSECUTIVE CASES

The objective of this study was to assess the usefulness of stereotact ic large-core needle biopsy (LCNB) in the management of nonpalpable br east lesions (NBL) and compare it with stereotactic fine-needle aspira tion biopsy (SFNA) performed simultaneously in a significant number of cases. From November 1993 through June 1997, 510 consecutive patients with NBL underwent 14-gauge LCNB with 354 women undergoing simultaneo us 21-gauge SFNA in the same lesion. Mammographic findings, lesion siz e, number of core biopsy specimens, complications and diagnoses of bot h techniques were analysed. Surgical biopsy, tumorectomy or mastectomy was indicated for malignancy or poor correlation between SNFA or LCNB results and clinical or radiological findings. Values of diagnostic a ccuracy of both LCNB and SFNA were determined. The ratio benign surgic al biopsies/malignant surgical biopsies (BB/CB) of the series was calc ulated. A total of 171 patients underwent surgical treatment; in 31 (1 8.1%) a benign process or atypical ductal hyperplasia was the final di agnosis. The ration BB/CB was 0.22. Sensitivity and specificity were 9 3.2 and 100%, respectively, for LCNB, and 77.2 and 92.3%, respectively , for SFNA with cytological analysis. Large-core needle biopsy provide s more accurate diagnosis than SFNA in the management of nonpalpable b reast lesions and obviates a surgical diagnostic procedure in a signif icant number of cases.