Stereotactic breast biopsy: initial experience and recommendations for improvement.

The results of 54 stereotactic core breast biopsies performed at Bishop Clarkson Memorial Hospital were reviewed. In 47 biopsies (87% of the total), a definitive diagnosis of either benign or malignant was made. Two biopsies (4% of the total) were classified as missed, and 5 biopsies (9% of the total) were deemed indeterminate. To improve both the success of the procedure and patient management, six recommendations were made: Patients judged to be potentially uncooperative and inclined to move during the procedure should receive sedation. A post-biopsy, non-stereo film should be taken to determine whether additional stereotactic biopsies will be required to adequately sample the lesion. Lesions containing microcalcifications should have a specimen radiograph prior to completing the biopsy procedure. A history sheet including clinical and mammographic findings should be given to pathology along with the biopsy specimen to assist in the histologic interpretation. The radiologist should review the pathology results in order to determine if a miss has occurred and additional biopsy is indicated. Six-month follow-up mammograms are to be required following a benign stereotactic biopsy diagnosis.