[Biopsy with large diameter needle in breast lesions].

INTRODUCTION

Breast cancer is the most ordinary cause of death by cancer in women whose ages range from 40 to 50. A primary prevention is impossible, so early diagnosis to improve the prognosis of the disease is necessary. A great importance is given to clinical examination and mammography that, however, has a limited specificity; so a biopsy is required for diagnosis. Surgical biopsy achieves this objective but isn't well accepted by patients and the costs/benefit ratio isn't always advantageous. That's why, in recent years, the use of fine needle aspiration has spread widely. However it is invalidated by an incidence of false negatives (5%-20%) and by a percentage of "inadequate", results of around 10%. The authors report the results of a technique of macrobiopsy with a needle to a large diameter in 60 women with radiologically suspect breast lesions.

MATERIALS AND METHODS

Since April 1990 to the present we have subjected 60 women with radiologically suspect mammary nodules with a diameter from 1 to 3 cm (means 1.2 cm) to a needle biopsy. The technique used is extremely simple and it requires the use of a needle with a diameter of 14 gauges, 114 mm long and with an automatic mechanism that grants an extremely precise taking.

RESULTS

35 (58%) of the tested women have been subjected to an operation and the histology confirmed the diagnosis. Other 25 (42%) women whose negative biopsy was followed by semestral clinical examination and with mammography once a year. None of them has developed a neoplastic disease.

DISCUSSION AND CONCLUSIONS

Surgical biopsy is the only safe test for the radiological suspicion of mammary lesions. In our experience large diameter needle biopsy that we have used combines the advantages of surgical biopsy with less invasivity. As a consequence we have better patient tolerability and lower incidence of false negatives in comparison with the cytological examination on fine needle aspiration that is often limited by inadequacy of the material. The proposed technique can be used in the out-clinic and could be made even more precise by the TRC mammotest or echography that enables to lead the needle into the lesion with a greater precision.