Percutaneous imaging-guided core breast biopsy: 5 years' experience in a community hospital

OBJECTIVE. This study reports the results of a percutaneous imaging-guided core breast biopsy program in a community hospital. MATERIALS AND METHODS. We reviewed the prospectively collected results of o ur imaging-guided core biopsy program during its first 5 years (1994-1998). A total of 1333 lesions (94% of which were Breast Imaging Reporting and Da ta System (BI-RADS) assessment category 4) were sampled in 1183 patients. P atients with BI-RADS assessment category 5 lesions were referred to surgeon s. Stereotactic guidance was used for the core biopsy of 506 lesions, and s onography was used to guide the predominantly 16-gauge needle core biopsy o f 827 solid masses. RESULTS. One hundred forty-seven cancers were diagnosed in 1333 biopsies, r esulting in a positive yield of 11%. Of 1020 patients with benign, concorda nt core biopsy results, 981 (96%) had at least one follow-up imaging examin ation within 36 months of the biopsy. Nineteen (2%) of these 1020 patients had a suspicious change at follow-up; 18 of these patients underwent surgic al excision with benign findings. No cancers were found at imaging follow-u p or by tumor registry linkage. All malignant core biopsy results were conf irmed as malignant at surgical excision (positive predictive value 100%). T wenty-two patients with atypical ductal hyperplasia at core biopsy had subs equent surgery, and 12 (55%) of them were found to have cancer at surgery. CONCLUSION. An imaging-guided core biopsy program, developed and implemente d by a small group of radiologists in a community hospital, can achieve suc cessful results and provide an important service to patients and a cost-eff ective alternative to surgical biopsy. Our program emphasized sonographic g uidance and achieved high follow-up compliance.