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Stereotactic and ultrasound-guided breast biopsy

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Abstract

Percutaneous imaging-guided needle biopsy has increasingly become an alternative to surgical biopsy for the histologic assessment of breast lesions. Percutaneous biopsy is faster, less invasive, and less expensive than surgical biopsy. Tissue acquisition is performed with automated core needles or directional vacuum-assisted biopsy probes. Guidance for percutaneous biopsy is usually provided by stereotaxis, ultrasound, and, more recently, under the guidance of MR imaging. Imaging guidance depends on lesion type and the results of diagnostic imaging studies. This article reviews indications, advantages, limitations, and controversial issues in percutaneous imaging-guided biopsy of breast lesions under stereotactic and ultrasound guidance. The potential for new research opportunities and directions is also discussed.

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References

  1. Heywang-Köbrunner SH, Schreer I (eds) (2003) Bildgebende Mammadiagnostik. Untersuchungstechnik, Befundmuster und Differentialdiagnostik in Mammaographie, Sonographie und Kernspintomographie, 2nd edn. Thieme, Stuttgart

  2. Helbich TH (2000) Contrast-enhanced MR imaging of the breast. Eur J Radiol 34:208–219

    Article  CAS  PubMed  Google Scholar 

  3. Perry NM (2001) Quality assurance in the diagnosis of breast disease. EUSOMA Working Party. Eur J Cancer 37:159–172

    CAS  Google Scholar 

  4. Parker SH, Lovin JD, Jobe WE, Burke BJ, Hopper KD, Yakes WF (1991) Nonpalpable breast lesions: stereotactic automated large-core biopsies. Radiology 180:403–407

    CAS  PubMed  Google Scholar 

  5. Parker SH, Jobe WE, Dennis MA et al. (1993) US-guided automated large-core breast biopsy. Radiology 187:507–511

    CAS  PubMed  Google Scholar 

  6. Parker SH, Burbank F, Jackman RJ et al. (1994) Percutaneous large-core breast biopsy: a multi-institutional study. Radiology 193:359–364

    CAS  PubMed  Google Scholar 

  7. Liberman L, Dershaw DD, Rosen PP, Abramson AF, Deutch BM, Hann LE (1994) Stereotaxic 14-gauge breast biopsy: How many core biopsy specimens are needed? Radiology 192:793–795

    CAS  PubMed  Google Scholar 

  8. Liberman L, Fahs MC, Dershaw DD, Bonaccio E, Abramson AF, Cohen MA, Hann LE (1995) Impact of stereotaxic core breast biopsy on cost of diagnosis. Radiology 195:633–637

    CAS  PubMed  Google Scholar 

  9. Wunderbaldinger P, Wolf G, Turetschek K, Helbich TH (2002) Comparison of sitting versus prone position for stereotactic large-core breast biopsy in surgically proven lesions. Am J Roentgenol 178:1221–1225

    Google Scholar 

  10. Welle GJ, Clark M, Loos S, Pauls D, Warden D, Sheffield M, Parsells C (2000) Stereotactic breast biopsy: recumbent biopsy using add-on upright equipment. Am J Roentgenol 175:59–63

    CAS  Google Scholar 

  11. Liberman L, Evans WP III, Dershaw DD, Hann LE, Deutch BM, Abramson AF, Rosen PP (1994) Radiography of microcalcifications in stereotaxic mammary core biopsy specimens. Radiology 190:223–225

    CAS  PubMed  Google Scholar 

  12. Helbich TH, Mayr W, Schick S et al. (1997) Coaxial technique: approach to breast core biopsies. Radiology 203:684–690

    CAS  PubMed  Google Scholar 

  13. Jackman RJ, Nowels KW, Rodriguez-Soto J, Marzoni FA, Finkelstein SI, Shepard MJ (1999) Stereotactic, automated, large-core needle biopsy of nonpalpable breast lesions: false-negative and histologic underestimation rates after long-term follow-up. Radiology 210:799–805

    CAS  PubMed  Google Scholar 

  14. Liberman L, Cohen MA, Dershaw DD et al. (1995) Atypical ductal hyperplasia diagnosed at stereotaxic core biopsy of breast lesions: an indication for surgical biopsy. Am J Roentgenol 164:1111–1113

    CAS  Google Scholar 

  15. Helbich TH, Rudas M, Haitel A, Kohlberger PD, Thurnher M, Gnant M, Wunderbaldinger P, Wolf G, Mostbeck GH (1998) Evaluation of needle size for breast biopsy: comparison of 14-, 16-, and 18-gauge biopsy needles. Am J Roentgenol 171:59–63

    CAS  Google Scholar 

  16. Melotti MK, Berg WA (2000) Core needle breast biopsy in patients undergoing anticoagulation therapy: preliminary results. Am J Roentgenol 174:245–249

    CAS  Google Scholar 

  17. Lee CH, Carter D, Philpotts LE, Couce ME, Horvath LJ, Lange RC, Tocino I (2000) Ductal carcinoma in situ diagnosed with stereotactic core needle biopsy: Can invasion be predicted? Radiology 217:466–470

    CAS  PubMed  Google Scholar 

  18. Darling MLR, Smith DN, Lester SC, Kaelin C, Selland DL, Denison CM et al. (2000) Atypical ductal hyperplasia and ductal carcinoma in situ as revealed by large-core needle breast biopsy: results of surgical excision. Am J Roentgenol 175:1341–1346

    CAS  Google Scholar 

  19. Liberman L, Drotman M, Morris EA, LaTrenta LR, Abramson AF, Zakowski MF, Dershaw DD (2000) Imaging–histologic discordance at percutaneous breast biopsy. Cancer 89:2538–2546

    Article  CAS  PubMed  Google Scholar 

  20. Lee CH, Philpotts LE, Horvath LJ, Tocino I (1999) Follow-up of breast lesions diagnosed as benign with stereotactic core-needle biopsy: frequency of mammographic change and false-negative rate. Radiology 212:189–194

    CAS  PubMed  Google Scholar 

  21. Helbich TH, Rudas M, Bohm G, Huber S, Wagner T, Taucher S, Wolf G, Mostbeck GH (1999) Randomized in vitro and in vivo evaluation of different biopsy needles and devices for breast biopsy. Clin Radiol 54:56–62

    CAS  PubMed  Google Scholar 

  22. Buchberger W, Niehoff A, Obrist P, Rettl G, Dunser M (2002) Ultraschallgezielte Stanzbiopsie der Mamma: Technik, Ergebnisse, Indikationen. Radiologe 42:25–32

    Google Scholar 

  23. Memarsadeghi M, Pfarl G, Riedl C, Wagner T, Rudas M, Helbich TH (2003) Value of 14-gauge ultrasound-guided large-core needle biopsy of breast lesions: own results in comparison with the literature. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 175:374–380

    Article  CAS  PubMed  Google Scholar 

  24. Smith DN, Rosenfield Darling ML, Meyer JE, Denison CM, Rose DI, Lester S, Richardson A, Kaelin CM, Rhei E, Christian RL (2001) The utility of ultrasonographically guided large-core needle biopsy: results from 500 consecutive breast biopsies. J Ultrasound Med 20:43–49

    CAS  PubMed  Google Scholar 

  25. Schulz-Wendtland R, Krämer S, Lang N, Bautz W (1998) Ultrasonic guided microbiopsy in mammary diagnosis: indications, technique and results. Anticancer Res 18:2145–2146

    CAS  PubMed  Google Scholar 

  26. Schoonjans JM, Brem RF (2001) Fourteen-gauge ultrasonographically guided large-core needle biopsy of breast masses. Ultrasound Med 20:967–972

    CAS  Google Scholar 

  27. Simon JR, Kalbhen CL, Cooper RA, Flisak ME (2000) Accuracy and complication rates of US-guided vacuum-assisted core breast biopsy: initial results. Radiology 215:694–697

    CAS  PubMed  Google Scholar 

  28. Burbank F, Parker SH, Fogarty TJ (1996) Stereotactic breast biopsy: improved tissue harvesting with the Mammotome. Am Surg 62:738–744

    CAS  PubMed  Google Scholar 

  29. Liberman L, Hann LE, Dershaw DD, Morris EA, Abramson AF, Rosen PP (1997) Mammographic findings after stereotactic 14-gauge vacuum biopsy. Radiology 203:343–347

    CAS  PubMed  Google Scholar 

  30. Liberman L, Smolkin JH, Dershaw DD, Morris EA, Abramson AF, Rosen PP (1998) Calcification retrieval at stereotactic, 11-gauge, directional, vacuum-assisted breast biopsy. Radiology 208:251–260

    CAS  PubMed  Google Scholar 

  31. Heywang-Köbrunner SH, Schaumlöffel U, Viehweg P, Höfer H, Buchmann J, Lampe D (1998) Minimally invasive stereotaxic vacuum core breast biopsy. Eur Radiol 8:377–385

    Article  CAS  PubMed  Google Scholar 

  32. Philpotts LE, Shaheen NA, Carter D, Lange RC, Lee CH (1999) Comparison of rebiopsy rates after stereotactic core needle biopsy of the breast with 11-gauge vacuum suction probe versus 14-gauge needle and automatic gun. Am J Roentgenol 172:683–687

    CAS  Google Scholar 

  33. Liberman L, Dershaw DD, Morris EA, Abramson AF, Thornton CM, Rosen PP (1997) Clip placement after stereotactic vacuum-assisted breast biopsy. Radiology 205:417–422

    CAS  PubMed  Google Scholar 

  34. Reynolds HE, Poon CM, Goulet RJ, Lazaridis CL (1998). Biopsy of breast microcalcifications using an 11-gauge directional vacuum-assisted device. Am J Roentgenol 171:611–613

    CAS  Google Scholar 

  35. Liberman L, Dershaw DD, Rosen PP, Morris EA, Abramson AF, Borgen PI (1998) Percutaneous removal of malignant mammographic lesions at stereotactic vacuum-assisted biopsy. Radiology 206:711–715

    CAS  PubMed  Google Scholar 

  36. Liberman L, Vuolo M, Dershaw DD, Morris EA, Abramson AF, LaTrenta LR, Polini NM, Rosen PP (1999) Epithelia displacement after stereotactic 11-gauge directional vacuum-assisted breast biopsy. Am J Roentgenol 172:677–681

    CAS  Google Scholar 

  37. Brem RF, Behrndt VS, Sanow L, Gatewood OMB (1999) Atypical ductal hyperplasia: histologic underestimation of carcinoma in tissue harvested from impalpable breast lesions using 11-gauge stereotactically guided directional vacuum-assisted biopsy. Am J Roentgenol 172:1405–1407

    CAS  Google Scholar 

  38. Jackman RJ, Burbank F, Parker SH, Evans WP III, Lechner MC, Richardson TR, Smid AA, Borofsky HB, Lee CH, Goldstein HM, Schilling KJ, Wray AB, Brem RF, Helbich TH, Lehrer DE, Adler SJ (2001) Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates. Radiology 218:497–502

    CAS  PubMed  Google Scholar 

  39. Brem RF, Schoonjans JM, Goodman SN, Nolten A, Askin FB, Gatewood OM (2001) Nonpalpable breast cancer: percutaneous diagnosis with 11- and 8-gauge stereotactic vacuum-assisted biopsy devices. Radiology 219:793–796

    CAS  PubMed  Google Scholar 

  40. Apesteguia L, Mellado M, Saenz J, Cordero JL, Reparaz B, De Miguel C (2002) Vacuum-assisted breast biopsy on digital stereotaxic table of nonpalpable lesions non-recognizable by ultrasonography. Eur Radiol 12:638–645

    CAS  PubMed  Google Scholar 

  41. Jackman RJ, Birdwell RL, Ikeda DM (2002) Atypical ductal hyperplasia: Can some lesions be defined as probably benign after stereotactic 11-gauge vacuum-assisted biopsy, eliminating the recommendation for surgical excision? Radiology 224:548–554

    PubMed  Google Scholar 

  42. Liberman L, Kaplan JB, Morris EA, Abramson AF, Menell JH, Dershaw DD (2002) To excise or to sample the mammographic target: What is the goal of stereotactic 11-gauge vacuum-assisted breast biopsy? Am J Roentgenol 179:679–683

    Google Scholar 

  43. Helbich TH, Buchberger W, Rudas M (2002) Österreichisches Konsensuspapier: Stereotaktisch und Ultraschallgezielte Vakuumbiopsie von Brustläsionen. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 174:517–521

    PubMed  Google Scholar 

  44. Philpotts LE, Lee CH, Horvath LJ, Lange RC, Carter D, Tocino I (2000) Underestimation of breast cancer with 11-gauge vacuum suction biopsy. Am J Roentgenol 175:1047–1050

    CAS  Google Scholar 

  45. Pfarl G, Helbich TH, Riedl CC, Guth-Wagner T, Gnant M, Rudas M, Liberman L (2002) Stereotactic 11-gauge vacuum-assisted breast biopsy: a validation study. Am J Roentgenol 179:1503–1507

    Google Scholar 

  46. American College of Radiology (1998) Illustrated breast imaging reporting and data system (BI-RADSTM), 3rd edn. American College of Radiology, Reston, Virginia

  47. Vizcaino I, Gadea L, Andreo L et al. (2001) Short-term follow-up results in 795 nonpalpable probably benign lesions detected at screening mammography. Radiology 219:475–483

    CAS  PubMed  Google Scholar 

  48. Helbich TH, Pfarl G, Lomosschitz F, Stadler A, Rudas M, Wolf G (2000) Role of core needle breast biopsy in probably benign lesions. Radiology 217:527

    CAS  PubMed  Google Scholar 

  49. Liberman L (2000) Clinical management issues in percutaneous core breast biopsy. Radiol Clin North Am 38:791–807

    CAS  PubMed  Google Scholar 

  50. Lomoschitz FM, Helbich TH, Rudas M, Pfarl G, Linnau KF, Stadler A, Jackman RJ (2004) Stereotactic, prone, II-gauge, vacuum-assisted breast biopsy: influence of number of specimens on diagnostic accuracy. Radiology (in press)

  51. Pfarl G, Riedl CC, Fuchsjäger MH, Bloch BN, Kaindl E, Helbich TH (2002) Impact of decompression and dislocation of clips and hookwires after stereotactic placement: a prospective analysis. Radiology 225:512

    Google Scholar 

  52. Diaz LK, Wiley EL, Venta LA (1999) Are malignant cells displaced by large-core needle biopsy of the breast? Am J Roentgenol 173:1303–1313

    CAS  Google Scholar 

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Acknowledgement

This article was supported in part by a seeding grant from Ethicon Endo-Surgery, Johnson and Johnson, Vienna, Austria.

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  1. Department of Radiology, University of Vienna (AKH), Waehringer-Guertel 18–20, 1090, Vienna, Austria

    T. H. Helbich, W. Matzek & M. H. Fuchsjäger

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  1. T. H. Helbich
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  2. W. Matzek
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  3. M. H. Fuchsjäger
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Correspondence to T. H. Helbich.

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Helbich, T.H., Matzek, W. & Fuchsjäger, M.H. Stereotactic and ultrasound-guided breast biopsy. Eur Radiol 14, 383–393 (2004). https://doi.org/10.1007/s00330-003-2141-z

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  • DOI: https://doi.org/10.1007/s00330-003-2141-z

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