Contrast-Enhanced Stereotactic Biopsy (CESB): Patient selection and practical considerations.

Area of Science:

• Breast Imaging
• Interventional Radiology
• Oncology

Background:

• Contrast-enhanced mammography (CEM) has emerged as a significant diagnostic tool in breast imaging since 2012.
• CEM demonstrates diagnostic accuracy comparable to breast MRI, offering a cost-effective alternative, particularly where MRI access is limited.

Purpose of the Study:

• To review the emerging technique of contrast-enhanced stereotactic biopsy (CESB) for diagnosing 'CEM-only' lesions.
• To outline patient selection criteria, procedural details, and key considerations for CESB.
• To provide an overview of the current literature on CESB.

Main Methods:

• This narrative review synthesizes current literature on contrast-enhanced stereotactic biopsy (CESB).
• It covers patient selection, procedural steps, and essential considerations for performing CESB.
• The review examines the role of CESB as an alternative to MRI-guided biopsy for specific breast lesions.

Main Results:

• CEM can identify 'CEM-only' lesions, which lack corresponding findings on other imaging modalities.
• MRI-guided biopsy is the current standard for these lesions.
• Contrast-enhanced stereotactic biopsy (CESB) has become commercially available since 2020 as a new alternative.

Conclusions:

• CESB presents a viable and potentially more accessible alternative for biopsy of 'CEM-only' lesions identified on contrast-enhanced mammography.
• Further research and clinical experience will solidify the role of CESB in breast cancer diagnosis.
• This review provides a foundational understanding for clinicians considering or implementing CESB.