[Stereotactic biopsy for non-palpable breast lesions: evaluation and choice of minimal invasive and excisional biopsy].
OBJECTIVE
To evaluate three biopsy methods which are currently used in stereotactic breast biopsy.


METHODS
A total of 361 cases of stereotactic breast biopsies were carried out since 2000, including 73 cases of true cut core needle biopsies (ST-CNB), 74 cases of vacuum assisted biopsies (ST-VAB) and 214 cases of excisional biopsies. After medium follow-up time of 18 months (6 to 66 months), the accuracy as well as the clinical benefits of the three stereotactic biopsy procedures were analyzed retrospectively.


RESULTS
The cancer miss rate of stereotactic wire localized excisional biopsy, ST-CNB and ST-VAB is 0, 2.7% and 0 respectively. Under-estimate rate of minimal invasive biopsy was 33% in atypical ductal hyperplasia (ADH) and 53% in ductal carcinoma in situ (DCIS). The minimal invasive procedure is superior to surgical procedure in terms of operation time, breast cosmetic outcome and complications, etc. Furthermore, 69% of the surgeries for suspicious lesion were waived.


CONCLUSIONS
Stereotactic minimal invasive breast biopsy, especially ST-VAB, is an accurate, safty and convenient diagnosis technique and could be considered as the first line choice for mammographic moderate suspicious breast lesions (BIRADS-4). However, further excisional biopsy is recommended for atypical hyperplasia. Stereotactic excisional biopsy could be directly used for diagnosis of mammographic highly suspicious breast lesions (BIRADS-5).
Liu
Guang-yu
GY
Department of Breast Surgery, Cancer Hospital, Fudan University, Shanghai 200032, China. liugy123@yahoo.com
Chen
Can-ming
CM
Hu
Zhen
Z
Ling
Hong
H
Shen
Kun-wei
KW
Shen
Zhen-zhou
ZZ
Shao
Zhi-min
ZM
D001706:Biopsy / Q000379:methods; D001707:Biopsy, Needle / Q000295:instrumentation; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D012680:Sensitivity and Specificity