Percutaneous imaging-guided core breast biopsy: 5 years' experience in a community hospital.
OBJECTIVE
This study reports the results of a percutaneous imaging-guided core breast biopsy program in a community hospital.


METHODS
We reviewed the prospectively collected results of our imaging-guided core biopsy program during its first 5 years (1994-1998). A total of 1333 lesions (94% of which were Breast Imaging Reporting and Data System (BI-RADS) assessment category 4) were sampled in 1183 patients. Patients with BI-RADS assessment category 5 lesions were referred to surgeons. Stereotactic guidance was used for the core biopsy of 506 lesions, and sonography was used to guide the predominantly 16-gauge needle core biopsy of 827 solid masses.


RESULTS
One hundred forty-seven cancers were diagnosed in 1333 biopsies, resulting in a positive yield of 11%. Of 1020 patients with benign, concordant core biopsy results, 981 (96%) had at least one follow-up imaging examination within 36 months of the biopsy. Nineteen (2%) of these 1020 patients had a suspicious change at follow-up; 18 of these patients underwent surgical excision with benign findings. No cancers were found at imaging follow-up or by tumor registry linkage. All malignant core biopsy results were confirmed as malignant at surgical excision (positive predictive value 100%). Twenty-two patients with atypical ductal hyperplasia at core biopsy had subsequent surgery, and 12 (55%) of them were found to have cancer at surgery.


CONCLUSIONS
An imaging-guided core biopsy program, developed and implemented by a small group of radiologists in a community hospital, can achieve successful results and provide an important service to patients and a cost-effective alternative to surgical biopsy. Our program emphasized sonographic guidance and achieved high follow-up compliance.
Margolin
F R
FR
Breast Health Center, Department of Radiology, California Pacific Medical Center, 3698 California St., 2/F, San Francisco, CA 94118, USA.
Leung
J W
JW
Jacobs
R P
RP
Denny
S R
SR
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation*; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000145:classification / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000145:classification / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000145:classification / Q000473:pathology; D005260:Female; D018226:Fibroadenoma / Q000145:classification / Q000473:pathology; D005348:Fibrocystic Breast Disease / Q000145:classification / Q000473:pathology; D005500:Follow-Up Studies; D006764:Hospitals, Community; D006801:Humans; D006965:Hyperplasia; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000295:instrumentation*