The role of stereotactic biopsy in abnormal mammograms

Core needle biopsy using either stereotactic or ultrasonographic guidance is a reasonable and accurate alternative to surgical biopsy for diagnosis of most nonpalpable breast lesions. An important component of a stereotactic core breast biopsy procedure is the mammographic and pathologic correlation of findings to plan optimal patient management. The level of suspicion of a mammographic lesion, the accuracy of stereotactic targeting, and the confirmation of microcalcifications in specimen radiographs for calcified lesions must be considered carefully and correlated with the histopathologic findings. Meticulous operator technique is essential to provide representative samples of the mammographic abnormality. Properly performed, imaging-guided percutaneous core breast biopsy has reduced the morbidity of surgical breast biopsy and the overall cost of breast cancer diagnosis. Recent work has demonstrated that stereotactic core breast biopsy can reduce the cost of diagnosing mammographically detected breast lesions by more than 50%. At a time when health-care policy and reimbursement decisions are influenced by cost considerations, increased use of stereotactic core breast biopsy is anticipated. Meticulous attention to technique allows maximal realization of the benefits of this procedure.