Stereotactic breast biopsy in a community hospital setting

Our institution began using a stereotactic core needle breast biopsy system for mammographically detected breast lesions in November 1996. The system consists of a LORAD stereo imaging table and an Ii-gauge vacuum-assisted ma mmotome (Biopsys Medical, Irvine, CA). All biopsies were performed with the combined efforts of a radiologist and a surgeon. Three hundred sixteen bio psies were attempted in 279 patients, with multiple biopsies in 31 patients . Indications included microcalcifications in 52 per cent of patients and a mass in 48 per cent of patients. Biopsy was unsuccessful in 20 patients (6 .3%). Pathologic diagnoses included invasive ductal carcinoma (19 patients) , invasive lobular carcinoma (2), ductal carcinoma in situ (17), atypical d uctal hyperplasia (8), atypical lobular hyperplasia (1), fibroadenoma (40), lymph node (7), and benign (202). Invasive cancer, in situ carcinoma, or a typical hyperplasia was diagnosed in 46 (15.6%) lesions. Thirty-six patient s had open biopsies. The core biopsy diagnosis was correct in 27 lesions, u nable to be confirmed in six cases and changed in four cases, with three le sions upgraded and one case downgraded. The ii-gauge vacuum-assisted mammot ome provides excellent accuracy for diagnosing mammographic abnormalities. A combined effort between radiology and surgical services is an effective w ay of using the stereotactic biopsy system.