Large-core needle biopsy of nonpalpable breast lesions

Abstract

Context: An increasing number of nonpalpable abnormalities requiring breast biopsy are being identified due to the widespread use of screening mammography. Large-core needle biopsy (LCNB) has become an alternative to surgical excision.

Objective: To determine whether LCNB is a safe and accurate technique to evaluate nonpalpable abnormalities found on breast imaging studies.

Design and setting: Case series at an institutional referral center from August 1, 1991, to December 31, 1997.

Patients: A total of 1643 women with 1 or more suspicious breast abnormalities received LCNBs (n = 1836 lesions).

Intervention: The LCNB of the breast uses a 14- or 11-gauge needle with stereotactic localization or ultrasound guidance.

Main outcome measure: Utility and potential limitations of LCNB compared with the criterion standard, surgical excision after wire localization.

Results: Of the 1836 breast lesions sampled, 444 (24%) were found to be malignant. A total of 412 (22%) were found to be malignant on the initial LCNB and 202 repeat biopsies yielded 32 additional malignancies. Complications were infrequent: 1 patient experienced a superficial infection and 1 developed a pneumothorax after LCNB.

Conclusion: Image-guided LCNB is a reliable diagnostic alternative to surgical excision of suspicious nonpalpable breast abnormalities.