Stereotactic core-needle breast biopsy: a multi-institutional prospective trial.

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Accurate diagnosis of nonpalpable breast lesions is crucial for effective treatment.
• Stereotactic core-needle biopsy (CNB) is a minimally invasive technique used for breast lesion evaluation.
• Assessing the accuracy of CNB requires careful consideration of potential diagnostic pitfalls.

Purpose of the Study:

• To evaluate the diagnostic accuracy of stereotactic core-needle biopsy (CNB) for nonpalpable breast lesions.
• To analyze the impact of anticipated tissue-sampling error on CNB accuracy.
• To determine the concordance of CNB findings with mammographic assessments.

Main Methods:

• Core-needle biopsy (CNB) was performed on 1,003 patients.
• Results were validated through surgical correlation or clinical/mammographic follow-up (median 24 months).
• Diagnostic discrimination measures (strict, working, applied) were used to assess accuracy, considering sampling error and imaging concordance.

Main Results:

• Strict, working, and applied sensitivities were 91%, 92%, and 98%, respectively.
• Strict, working, and applied specificities were 100%, 98%, and 73%, respectively.
• Overall accuracies for the three measures were 97%, 96%, and 79%.

Conclusions:

• Percutaneous stereotactic CNB is a reliable method for histopathologic diagnosis of nonpalpable breast lesions.
• CNB accuracy is improved by addressing potential sampling errors and discordant imaging findings.
• Understanding the interplay of sampling error and imaging concordance is vital for accurate interpretation of CNB results.