Bick Ulrich, Trimboli Rubina M, Athanasiou Alexandra, Balleyguier Corinne, Baltzer Pascal A T, Bernathova Maria, Borbély Krisztina, Brkljacic Boris, Carbonaro Luca A, Clauser Paola, Cassano Enrico, Colin Catherine, Esen Gul, Evans Andrew, Fallenberg Eva M, Fuchsjaeger Michael H, Gilbert Fiona J, Helbich Thomas H, Heywang-Köbrunner Sylvia H, Herranz Michel, Kinkel Karen, Kilburn-Toppin Fleur, Kuhl Christiane K, Lesaru Mihai, Lobbes Marc B I, Mann Ritse M, Martincich Laura, Panizza Pietro, Pediconi Federica, Pijnappel Ruud M, Pinker Katja, Schiaffino Simone, Sella Tamar, Thomassin-Naggara Isabelle, Tardivon Anne, Ongeval Chantal Van, Wallis Matthew G, Zackrisson Sophia, Forrai Gabor, Herrero Julia Camps, Sardanelli Francesco
Clinic of Radiology, Charité Universitätsmedizin Berlin, 10117, Berlin, Germany.
PhD Course in Integrative Biomedical Research, Department of Biomedical Science for Health, Università degli Studi di Milano, Via Mangiagalli, 31, 20133, Milan, Italy.
Insights Imaging. 2020 Feb 5;11(1):12. doi: 10.1186/s13244-019-0803-x.
We summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriate combination of device type for sampling and imaging technique for guidance. Then, we describe the commonly used devices, from fine-needle sampling to tissue biopsy with larger needles, namely core needle biopsy and vacuum-assisted biopsy, and how mammography, digital breast tomosynthesis, ultrasound, or magnetic resonance imaging work for targeting the lesion for sampling or localisation. The differences among the techniques available for localisation (carbon marking, metallic wire, radiotracer injection, radioactive seed, and magnetic seed localisation) are illustrated. Type and rate of possible complications are described and the issue of concomitant antiplatelet or anticoagulant therapy is also addressed. The importance of pathological-radiological correlation is highlighted: when evaluating the results of any needle sampling, the radiologist must check the concordance between the cytology/pathology report of the sample and the radiological appearance of the biopsied lesion. We recommend that special attention is paid to a proper and tactful approach when communicating to the woman the need for tissue sampling as well as the possibility of cancer diagnosis, repeat tissue sampling, and or even surgery when tissue sampling shows a lesion with uncertain malignant potential (also referred to as "high-risk" or B3 lesions). Finally, seven frequently asked questions are answered.
我们在此总结了要向女性及转诊医生提供的关于经皮乳房活检及影像引导下病变定位的信息。在解释了为何经皮活检进行术前诊断优于手术活检后，我们阐述了放射科医生用于选择最合适的采样设备类型及引导成像技术组合的标准。然后，我们描述了常用设备，从细针采样到使用较大针具的组织活检，即粗针活检和真空辅助活检，以及乳腺X线摄影、数字乳腺断层合成、超声或磁共振成像如何用于针对病变进行采样或定位。阐述了可用于定位的技术（碳标记、金属丝、放射性示踪剂注射、放射性种子和磁性种子定位）之间的差异。描述了可能并发症的类型和发生率，还讨论了同时进行抗血小板或抗凝治疗的问题。强调了病理 - 放射学相关性的重要性：在评估任何针吸采样结果时，放射科医生必须检查样本的细胞学/病理报告与活检病变的放射学表现之间的一致性。我们建议，在告知女性组织采样的必要性以及癌症诊断、重复组织采样甚至手术的可能性（当组织采样显示具有不确定恶性潜能的病变时，也称为“高危”或B3病变）时，要采取恰当且得体的方式。最后，回答了七个常见问题。
