STEREOTAXIC CORE NEEDLE-BIOPSY AND THE WORK-UP OF MAMMOGRAPHIC BREAST-LESIONS

Objective: To evaluate the influence of stereotactic core needle biops y (SCNB) as an alternative to wire localization biopsy (WLB) on the ev aluation and workup of nonpalpable mammographic lesions. Design: A 4-y ear retrospective clinical review. Setting: University hospital and cl inics. Patients: All patients evaluated for nonpalpable mammographic l esions after screening, diagnostic mammography, or both during the 4-y ear period of the study were included. Outcome Parameters: Changes in the number and types of mammograms and diagnostic biopsies and the his tologic findings using each technique (SCNB vs WLB), including total n umber of cancers diagnosed. Results: The number of screening mammogram s and WLBs performed remained constant compared with a marked increase in the number of diagnostic mammograms and SCNBs. The rates of positi ve findings for each biopsy technique were consistent while the total number of cancers diagnosed increased dramatically. The percentage of biopsy specimens with positive results (ductal carcinoma in situ and i nvasive cancers) for SCNB was 13.3% compared with 26.2% for WLB specim ens. There has also been an increase in the number of cancers found, f rom 22 in the first year to 54 in the fourth year. In the first year, 45% of these cancers were diagnosed by SCNB; in the fourth year, 83% o f the cancers were diagnosed by SCNB. Conclusion: Stereotactic core ne edle biopsy has replaced WLB as the standard for the diagnostic biopsy of suspicious, nonpalpable mammographic lesions. Since adopting this technique, more patients have been examined and their conditions diagn osed as breast: cancer in an efficient, cost-effective manner.