Recent developments in stereotactic breast biopsy methodologies: an update for the surgical pathologist

Area of Science:

• Radiology
• Surgical Pathology

Background:

• Nonpalpable, mammographically detected lesions require accurate tissue sampling.
• Advancements in stereotactic biopsy technology aim to improve diagnostic yield and lesion assessment.

Purpose of the Study:

• To review and compare new devices for stereotactic biopsy of mammographically detected breast lesions.
• To present specimen handling protocols and discuss the potential of these new biopsy techniques.

Main Methods:

• Review of vacuum-assisted core biopsy (VACB) and advanced breast biopsy instrumentation (ABBI) systems.
• Discussion of stereotactic guidance and tissue acquisition mechanisms (circumferential multi-core vs. single large-core).

Main Results:

• VACB (11-gauge) provides more complete sampling than 14-gauge stereotactic core biopsy, reducing unsatisfactory biopsies.
• ABBI obtains a single large core (5-20 mm) for potential complete lesion assessment, though its treatment role is under investigation.

Conclusions:

• New stereotactic biopsy devices offer improved sampling for mammographic lesions.
• Further data collection through radiologist and surgeon collaboration is essential to evaluate the strengths and weaknesses of VACB and ABBI.