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Canceled stereotactic core-needle biopsy of the breast: analysis of 89 cases
L E Philpotts1, C H Lee, L J Horvath
1Department of Diagnostic Radiology, Yale University, School of Medicine, New Haven, CT 06520, USA.
Purpose:
To determine reasons for cancellation of stereotactic core-needle breast biopsy and outcome in canceled cases.
Materials And Methods:
Among 572 scheduled stereotactic core-needle biopsies, 89 cases (16%) in 88 patients were canceled. In canceled cases, mammogram origin, mammographic abnormality, reason for cancellation, and outcome were determined.
Results:
In canceled cases, 50 (57%) of 88 patients were referred from another facility. Mammographic abnormality in most cases (72 [81%] of 89 canceled biopsies) was a mass(es); calcifications occurred in 14 cases (16%). Reasons for cancellation included (a) lesion was not recognized (26 cases [29%]), (b) lesion was reassessed as benign (17 cases [19%]), (c) cysts were diagnosed with ultrasound (US) (12 cases [13%]) or aspiration (11 cases [12%]), (d) lesion location was suboptimal (12 cases [13%]), (e) patient was intolerant of procedure (seven cases [8%]), and (f) other (four cases [4%]). Numbers of canceled biopsies from another facility and those from the authors' institution differed in cases in which lesions were reassessed as benign (12 and five cases, respectively) or cysts were diagnosed with US (10 and two cases, respectively). Lesions that could not be targeted included many pseudolesions and three cancers.
Conclusion:
Complete work-up, including US examination, of breast lesions is necessary before stereotactic core-needle biopsy is scheduled. Inability to recognize a suspected lesion on stereotactic images should not preclude biopsy with another method.