title: Breast imaging for interventional pathologists.
abstract: BACKGROUND
  Pathologist-performed, ultrasound-guided fine-needle aspiration biopsy is one of the frontiers of pathology. The College of American Pathologists, American Society for Clinical Pathology, and American Society of Cytopathology offer courses and certificate programs for pathologists in this area. The courses emphasize the biopsy of masses in the thyroid and head and neck. There is little training in ultrasound-guided biopsy of breast masses. To successfully perform an imaging-guided biopsy of the breast, pathologists should understand the basics of mammography and breast ultrasound.
  
  
  OBJECTIVE
  To review the basics of mammography and breast ultrasound to help interventional pathologists add ultrasound-guided, fine-needle aspiration and core-needle biopsies of the breast to their list of core competencies.
  
  
  METHODS
  Classic and recent literature and textbooks on mammography and breast ultrasound.
  
  
  CONCLUSIONS
  The heart of early breast cancer detection is the screening mammogram. Abnormalities detected on screening, such as masses, densities, architectural distortions, nipple retraction, skin thickening, abnormal lymph nodes, and microcalcifications, will lead to a diagnostic mammogram and/or breast ultrasound. Lesions classified as Breast Imaging Reporting and Data System 4 or 5, and a few classified as 3 lesions, require biopsy. If the lesion is visible on ultrasound, ultrasound-guided fine-needle aspiration biopsy and/or core-needle biopsy is the procedure of choice. Suspicious lesions visible only on mammogram require stereotactic x-ray-guided biopsy. Interventional pathologists who understand the values and limitations of mammography and breast ultrasound are ready for the challenges of pathologist-performed, ultrasound-guided, fine-needle aspiration and core-needle biopsies of the breast.
authors.affiliation: Fine Needle Aspiration Medical Group, Alhambra, California 91801, USA. lifecmil@aol.com
authors.forename: David
authors.initials: D
authors.lastname: Lieu
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D002114:Calcinosis / Q000175:diagnosis; D003952:Diagnostic Imaging; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008327:Mammography / Q000266:history / Q000379:methods; D008403:Mass Screening; D011856:Radiographic Image Enhancement; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary / Q000266:history / Q000379:methods