Image-guided core biopsy in patients with breast disease

Ultrasonographically-guided core biopsy has been used as an adjunct to triple assessment when fine-needle aspiration cytology was inadequate or equivocal, if the overall assessment of the patient was uncertain, or if it was deemed the preferred diagnostic option. Some 143 of 2603 patients had a guided core biopsy, 125 to establish the diagnosis and 18 to obtain histology in cytologically proven malignancy. A diagnosis of malignancy was established in 43 of the 125 patients who had a diagnostic core biopsy. Some 45 patients with benign disease were either discharged or returned to follow-up on the basis of the core biopsy. The remaining 37 patients required surgical biopsy, of whom 13 had malignant and 24 benign disease. The overall positive predictive value for malignancy was 98 per cent. Experience with ultrasonographically-guided core biopsy shows that it can reduce the need for surgical biopsy in both benign and malignant conditions of the breast.