COMPARISON OF HISTOLOGIC DIAGNOSIS BETWEEN STEREOTAXIC CORE NEEDLE-BIOPSY AND OPEN SURGICAL BIOPSY

Background: This study correlates the histologic findings of stereotac tic core needle biopsy (SCNB) with open surgical biopsy (OSB) and iden tifies which lesions can be treated definitively based only on the SCN B histology. Methods: Women who underwent SCNB between July 1, 1993, a nd January 1, 1969, were identified by retrospective chart review. Mam mographic (MGM) lesions found by SCNB to be ductal or lobular hyperpla sia with atypia, or carcinoma underwent OSB. When the histologic findi ngs by SCNB were inconsistent with the MGM findings, the lesion also u nderwent OSB. Results: 799 women underwent SCNB with 96 (12%) of these going on to OSB. MGM findings in the 92 who presented without a palpa ble mass included microcalcifrcations (MCS) in 39, mass in 47, MCS and mass in 7, and tissue distortion in 3. One hundred one breast lesions biopsied first by SCNB, then by OSB were correlated histologically. S ensitivity of SCNB is 89%, with a specificity of 94%. Eight-four women (88%) were able to have definitive treatment at time of OSB because o f prior SCNB, and 703/799 (88%) of woman were spared OSB entirely. Con clusion: SCNB accurately identifies benign breast histology and invasi ve cancers in women with MGM abnormalities, a distinct advantage over fine needle aspiration cytology. SCNB does not reliably identify women with DCIS and invasion. All women with SCNB diagnosis of ductal or lo bular atypia should also undergo OSB.