CAR Practice Guidelines on Breast Imaging and Interventions: Breast Intervention and Biopsy Procedures

This guideline presents Part V of the Canadian Association of Radiologists (CAR) Practice Guidelines on Breast Imaging and Intervention and addresses image-guided breast intervention and biopsy procedures. This guideline provides comprehensive recommendations for stereotactic-, tomosynthesis-, ultrasound-, and MRI-guided biopsy, as well as preoperative localization and post-procedural management. Key areas include indications and contraindications, biopsy device and needle selection, tissue marker placement, documentation, radiologic-pathologic correlation, quality assurance, and personnel qualifications. Emphasis is placed on minimally invasive, image-guided procedures as the standard of care for diagnosing palpable and nonpalpable breast lesions. This guideline is intended to be used in conjunction with the other components of the CAR Breast Practice Guidelines series, which together replace the 2016 CAR Breast guidelines and reflect the current evidence base and clinical landscape in Canadian breast imaging. While outlining best practices and minimum standards, this guideline acknowledges variability in patient needs, lesion characteristics, and institutional resources, with ultimate responsibility for procedural decision-making residing with the supervising radiologist.