Needle-localized breast biopsy: why do we fail?
OBJECTIVE
To determine what factors are associated with unsuccessful needle-localized breast biopsy (NLBB).


METHODS
Findings in 280 consecutive nonpalpable breast lesions in 262 women (age range, 27-87 years; mean age, 55 years) who underwent nonstereotactic, mammographically guided, standardized NLBB were retrospectively analyzed according to mammographic lesion type, lesion size, number of lesions per breast, needle type, proximity of needle to lesion, radiologist, specimen size, surgeon, and histologic findings.


RESULTS
Biopsy failed in seven (2.5%) of 280 lesions. Failures were related to lesion type, lesion size, number of lesions per breast, accuracy of needle placement, and volume of tissue removed. Removal of more than one tissue specimen converted failure to success in 14 (67%) of 21 initially missed lesions, all microcalcifications.


CONCLUSIONS
Unsuccessful NLBB was more likely with two lesions per breast, small lesions, small specimens, and microcalcifications. Piercing such lesions with the localizing needle led to successful biopsy. Removal of more tissue was helpful with missed microcalcifications.
Jackman
R J
RJ
Department of Radiology, Palo Alto Medical Clinic, CA 94301, USA.
Marzoni
F A
FA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies