Stereotactic core needle biopsy and the workup of mammographic breast lesions.

OBJECTIVE

To evaluate the influence of stereotactic core needle biopsy (SCNB) as an alternative to wire localization biopsy (WLB) on the evaluation and workup of nonpalpable mammographic lesions.

DESIGN

A 4-year retrospective clinical review.

SETTING

University hospital and clinics.

PATIENTS

All patients evaluated for nonpalpable mammographic lesions after screening, diagnostic mammography, or both during the 4-year period of the study were included.

OUTCOME PARAMETERS

Changes in the number and types of mammograms and diagnostic biopsies and the histologic findings using each technique (SCNB vs WLB), including total number of cancers diagnosed.

RESULTS

The number of screening mammograms and WLBs performed remained constant compared with a marked increase in the number of diagnostic mammograms and SCNBs. The rates of positive findings for each biopsy technique were consistent while the total number of cancers diagnosed increased dramatically. The percentage of biopsy specimens with positive results (ductal carcinoma in situ and invasive cancers) for SCNB was 13.3% compared with 26.2% for WLB specimens. There has also been an increase in the number of cancers found, from 22 in the first year to 54 in the fourth year. In the first year, 45% of these cancers were diagnosed by SCNB; in the fourth year, 83% of the cancers were diagnosed by SCNB.

CONCLUSION

Stereotactic core needle biopsy has replaced WLB as the standard for the diagnostic biopsy of suspicious, nonpalpable mammographic lesions. Since adopting this technique, more patients have been examined and their conditions diagnosed as breast cancer in an efficient, cost-effective manner.