NEEDLE-LOCALIZED BREAST BIOPSY - WHY DO WE FAIL

PURPOSE: To determine what factors are associated with unsuccessful ne edle-localized breast biopsy (NLBB). MATERIALS AND METHODS: Findings i n 280 consecutive nonpalpable breast lesions in 262 women (age range, 27-87 years; mean age, 55 years) who underwent nonstereotactic, mammog raphically guided, standardized NLBB were retrospectively analyzed acc ording to mammographic lesion type, lesion size, number of lesions per breast, needle type, proximity of needle to lesion, radiologist, spec imen size, surgeon, and histologic findings. RESULTS: Biopsy failed in seven (2.5%) of 280 lesions. Failures were related to lesion type, le sion size, number of lesions per breast, accuracy of needle placement, and volume of tissue removed. Removal of more than one tissue specime n converted failure to success in 14 (67%) of 21 initially missed lesi ons, all microcalcifications. CONCLUSION: Unsuccessful NLBB was more l ikely with two lesions per breast, small lesions, small specimens, and microcalcifications. Piercing such lesions with the localizing needle led to successful biopsy. Removal of more tissue was helpful with mis sed microcalcifications.