Multiple 14G stereotactic core biopsies in the diagnosis of mammographically detected stellate lesions of the breast

AIM: The aim of this retrospective study was to measure the accuracy of ste reotactic guided 14 gauge core biopsy in distinguishing between benign and malignant causes of a mammographically detected stellate breast lesion and to assess the impact of the number of core samples taken on the sensitivity for detection of malignancy. MATERIALS AND METHODS: Seventy-two patients with mammographically detected stellate lesions of the breast formed the study group. All patients in the study group underwent multiple 14 gauge core biopsies using prone stereotac tic breast biopsy equipment. The diagnostic accuracy of the technique was m easured by retrospectively comparing the outcome with the core biopsy resul ts. The result of each core sample was separately recorded to allow analysi s of the effect of increasing the number of samples on accuracy. RESULTS: Nine of 72 (12%) did not have surgery. Forty of 72 (56%) had a ben ign surgical outcome and 23/72 (32%) a malignant surgical outcome [7/72 (10 %) non-invasive, 16/72 (22%) invasive carcinoma]. The absolute sensitivity for multiple stereotactic guided core biopsies of stellate lesions for the detection of malignancy was 78% with a complete sensitivity of 100%. The se nsitivity for the detection of invasive carcinoma was 94% (15 out of 16 pat ients). No statistically significant improvement in sensitivity was shown f or multiple samples vs one sample, but in two patients, malignant tissue wa s only found in core samples 6-9, the first five cores showing atypia only. CONCLUSION: Multiple stereotactic guided 14 gauge core biopsies accurately distinguish malignant from benign causes of stellate breast lesions. When c ore biopsy histology is malignant, therapeutic surgery can be planned, When the core biopsy shows typical features of a benign radial scar, diagnostic surgical excision may not be required to confirm the diagnosis, Kirwan, S. E., et al. (2000). Clinical Radiology 55, 763-766. (C) 2000 The Royal Coll ege of Radiologists.