Image-guided core-needle breast biopsy is an accurate technique to evaluate patients with nonpalpable imaging abnormalities

Fuhrman, G. M., Cederbom, G. J., Bolton, J. S., King, T. A., Duncan, J. L., Champaign, J. L., Smetherman, D. H., Farr, G. H., Kuske, R. R. and McKinnon, W. M. P. (1998). Image-guided core-needle breast biopsy is an accurate technique to evaluate patients with nonpalpable imaging abnormalities. In: 109th Annual Meeting of the Southern Surgical Association, Hot Springs, VA, United States, (932-937). 30 November -3 December 1997. doi:10.1097/00000658-199806000-00017


Author Fuhrman, G. M.
Cederbom, G. J.
Bolton, J. S.
King, T. A.
Duncan, J. L.
Champaign, J. L.
Smetherman, D. H.
Farr, G. H.
Kuske, R. R.
McKinnon, W. M. P.
Title of paper Image-guided core-needle breast biopsy is an accurate technique to evaluate patients with nonpalpable imaging abnormalities
Conference name 109th Annual Meeting of the Southern Surgical Association
Conference location Hot Springs, VA, United States
Conference dates 30 November -3 December 1997
Journal name Annals of Surgery   Check publisher's open access policy
Publisher Lippincott Williams & Wilkins
Publication Year 1998
Sub-type Fully published paper
DOI 10.1097/00000658-199806000-00017
ISSN 0003-4932
1528-1140
Volume 227
Issue 6
Start page 932
End page 937
Total pages 5
Language eng
Abstract/Summary Objective: The goal was to evaluate one institution's experience with image-guided core-needle breast biopsy (IGCNBB) and compare the pathologic results with wire-localized excisional breast biopsy (WLEBB) for patients with positive cores and the mammographic surveillance results for patients with negative cores. Summary Background Data: IGCNBB is becoming a popular, minimally invasive alternative to WLEBB in the evaluation of patients with nonpalpable abnormalities. Methods: This study includes all patients with nonpalpable breast imaging abnormalities evaluated by IGCNBB from July 1993 to February 1997. Patients with positive cores (atypical hyperplasia, carcinoma in situ, or invasive carcinoma) were evaluated by WLEBB. Patients with negative cores (benign histology) were followed with a standard mammographic protocol. IGCNBB results were compared with WLEBB results to determine the sensitivity and specificity for each IGCNBB pathologic diagnosis. Results: Of 1440 IGCNBBs performed during the study period, 1106 were classified as benign, and during surveillance follow-up only a single patient was demonstrated to have a carcinoma in the index part of the breast evaluated by IGCNBB (97.3% sensitivity, 99.7% specificity). IGCNBB demonstrated atypical hyperplasia in 72 patients, 5 of whom refused WLEBB. The remaining 67 patients were evaluated by WLEBB: nonmalignant findings were found in 31, carcinoma in situ was found in 25, and invasive carcinoma was found in 11 (100% sensitivity, 88.8% specificity). IGCNBB demonstrated carcinoma in situ in 84 patients; WLEBB confirmed carcinoma in situ in 54 and invasive carcinoma in 30 (65.4% sensitivity, 97.7% specificity). IGCNBB demonstrated invasive carcinoma in 178 patients. Three were lost to follow- up. On WLEBB, 173 of the remaining 175 had invasive carcinoma; the other 2 patients had carcinoma in situ (80.8% sensitivity, 99.8% specificity). Conclusions: An IGCNBB that demonstrates atypical hyperplasia or carcinoma in situ requires WLEBB to define the extent of breast pathology. Mammographic surveillance for a patient with a benign IGCNBB is supported by nearly 100% specificity. An IGCNBB diagnosis of invasive carcinoma is also associated with nearly 100% specificity; therefore, these patients can have definitive surgical therapy, including axillary dissection or mastectomy, without waiting for the pathologic results of a WLEBB. Based on the author's findings, IGCNBB can safely replace WLEBB in evaluating patients with nonpalpable breast abnormalities.
Keyword STEREOTAXIC CORE
ASPIRATION BIOPSY
SURGICAL BIOPSY
FOLLOW-UP
LESIONS
LOCALIZATION
MAMMOGRAPHY
EXPERIENCE
DIAGNOSIS
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 10:50:10 EST