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Consensus document on preoperative diagnostic procedures in breast lesions.

Stefano Marletta1,2, Isabella Castellano3, Francesca Caumo4

  • 1Division of Pathology, Humanitas Istituto Clinico Catanese, Catania, Italy.

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|July 8, 2025
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Summary

Percutaneous breast biopsies are essential for diagnosing lesions and guiding treatment. Accurate sampling and multidisciplinary team discussion ensure optimal patient management and effective therapy selection.

Keywords:
breast cancerconsensusmultidisciplinary managementpreoperative biopsy

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Area of Science:

  • Oncology
  • Pathology
  • Radiology

Background:

  • Percutaneous sampling via core needle or vacuum-assisted biopsy is standard for breast lesions.
  • Preoperative biopsies provide pathological diagnoses and prognostic/predictive data.
  • Adequate sampling is crucial for lesion categorization (B1-B5).

Purpose of the Study:

  • To provide a comprehensive overview of breast percutaneous biopsy techniques.
  • To detail diagnostic categories and multidisciplinary management strategies.
  • To emphasize evidence-based good clinical practice.

Main Methods:

  • Review of current percutaneous biopsy techniques (core needle, vacuum-assisted).
  • Analysis of diagnostic categorization (B1-B5) and key pathological features (histotype, ER, PR, Ki-67, HER2).
  • Integration of biopsy results with clinical and radiological findings for multidisciplinary team discussion.

Main Results:

  • Biopsies yield essential pathological diagnoses and predictive information.
  • Morphological and immunohistochemical features guide therapy, especially in the neoadjuvant setting.
  • Multidisciplinary discussion of biopsy results is key for treatment decisions, particularly for B3-B5 lesions.

Conclusions:

  • Percutaneous breast biopsies are critical for accurate diagnosis and patient management.
  • Comprehensive evaluation including pathological and molecular features informs effective treatment strategies.
  • Multidisciplinary integration of biopsy data ensures optimal clinical decision-making for breast lesions.