Large-Core Needle Biopsy of Nonpalpable Breast Lesions

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Abstract
ContextAn increasing number of nonpalpable abnormalities requiring breast biopsy are being identified due to the widespread use of screening mammography. Large-core needle biopsy (LCNB) has become an alternative to surgical excision.ObjectiveTo determine whether LCNB is a safe and accurate technique to evaluate nonpalpable abnormalities found on breast imaging studies.Design and SettingCase series at an institutional referral center from August 1, 1991, to December 31, 1997.PatientsA total of 1643 women with 1 or more suspicious breast abnormalities received LCNBs (n=1836 lesions).InterventionThe LCNB of the breast uses a 14- or 11-gauge needle with stereotactic localization or ultrasound guidance.Main Outcome MeasureUtility and potential limitations of LCNB compared with the criterion standard, surgical excision after wire localization.ResultsOf the 1836 breast lesions sampled, 444 (24%) were found to be malignant. A total of 412 (22%) were found to be malignant on the initial LCNB and 202 repeat biopsies yielded 32 additional malignancies. Complications were infrequent: 1 patient experienced a superficial infection and 1 developed a pneumothorax after LCNB.ConclusionImage-guided LCNB is a reliable diagnostic alternative to surgical excision of suspicious nonpalpable breast abnormalities.