title: Should all breast cancers be diagnosed by needle biopsy?
abstract: BACKGROUND
  Although much data support the National Quality Forum recommendation that breast cancers should be diagnosed by needle biopsy before surgical resection, the exclusion criteria for those that may not be suitable have yet to be defined.
  
  
  METHODS
  We reviewed all patients treated over the past 3 years at the Yale Breast Center to determine the percentage of patients not diagnosed by needle biopsy, and why.
  
  
  RESULTS
  Reasons for the 17% of 630 patients who were not diagnosed by needle biopsy were as follows: inability to cooperate (1%); small or superficial lesion less than 1 cm that technically was easier to excise in the office (4%); bloody discharge without clinical or mammographic mass (1%); lesion adjacent to implant (.5%); a mammographic lesion that was too posterior, too superficial, or too faint to be performed stereotactically (5%); or patient preference (5%).
  
  
  CONCLUSIONS
  Needle biopsy is the preferred method of diagnosis in most cases, but there are valid reasons why all breast cancers will not be diagnosed in this fashion.
authors.affiliation: Department of Surgery, Yale University School of Medicine, PO Box 208062, New Haven, CT 06520, USA. Donald.lannin@yale.edu
authors.forename: Donald R
authors.initials: DR
authors.lastname: Lannin
authors.forename: Teresa
authors.initials: T
authors.lastname: Ponn
authors.forename: Liva
authors.initials: L
authors.lastname: Andrejeva
authors.forename: Liane
authors.initials: L
authors.lastname: Philpotts
mesh_terms: D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted; D016217:Ultrasonography, Mammary