STEREOTAXIC BREAST BIOPSY - A SURGICAL SERIES

Background: Stereotactic core needle biopsy (SCNB) is increasing in po pularity and is currently being performed by both radiologists and sur geons. It has been shown to be accurate and cost effective, but the ap propriate use of SCNB in the probably benign mammographic lesion has n ot been determined, Nor has it been determined whether a learning curv e affects performance of the procedure. Study Design: The records of a ll patients undergoing SCNB by the author from August 1993 through May 1996 were reviewed, Two hundred forty-two patients underwent 244 proc edures, Indications for biopsy, results, and complications were examin ed. Results: Probably benign mass Tvas, the most common indication for biopsy (45%), and microcalcifications were the indication for biopsy in 24%, A diagnosis of cancer nas made in 11.1%. Patients with microca lcifications and probably benign masses were diagnosed with cancer in 18.4 and 1.8%, respectively. Three of eight patients undergoing open b iopsy for atypical hyperplasia were diagnosed with cancer, Accuracy ra te for the entire series was 97.7%, The effect of operator experience on the indication for SCNB was studied, As experience increased from t he first to the last third of the study, microcalcifications as an ind ication increased from 23.5-47.5%, During this same time period, ''pro bably benign'' mass decreased from 53.1-32.5%. Conclusion: This study demonstrates that accuracy of this surgical series is comparable to ot her published series, Biopsies for more difficult lesions were noted t o increase as operator experience increased, It was Likely that this ' 'learning curve'' was owing to improvements in technique and an increa sed confidence ire the accuracy of the procedure, With an incidence of cancer of less than 2% in patients with a probably benign mass, inter val mammography represents for many, a cost-effective alternative. (C) 1997 by the American College of Surgeons.