Breast biopsy techniques in a global setting-clinical practice review

Area of Science:

• Oncology
• Global Health
• Diagnostic Pathology

Background:

• Breast cancer is a significant global health issue with disparities in care between high- and low-income countries.
• Resource availability influences breast cancer management strategies, particularly regarding diagnostic techniques.
• Women in low-resource settings often present with larger, symptomatic tumors, necessitating adapted diagnostic approaches.

Purpose of the Study:

• To review variations in breast biopsy techniques between high- and low-income countries.
• To propose cost-effective breast biopsy strategies for resource-limited settings.
• To emphasize the importance of biopsy technique in influencing subsequent breast cancer therapy.

Main Methods:

• Review of current literature on breast biopsy techniques in different economic contexts.
• Analysis of the applicability of advanced versus cost-effective biopsy methods.
• Discussion of specimen handling, transportation, and preparation for optimal diagnostic yield.

Main Results:

• Developed countries utilize advanced percutaneous biopsy techniques for screening and image-detected lesions.
• Lower-income settings often manage palpable, larger tumors, requiring modified, cost-conscious strategies.
• Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) can achieve high accuracy with proper technique and specimen management.

Conclusions:

• Equitable breast cancer care requires adapting biopsy strategies to local resource availability.
• Cost-effective methods like FNAC and CNB, when meticulously performed, provide adequate diagnostic information.
• Implementing appropriate breast biopsy techniques in resource-limited countries is crucial for effective breast cancer management.