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Interventional breast procedures
E S de Paredes1, T G Langer, J Cousins
1Department of Radiology, Medical College of Virginia of Virginia Commonwealth University, USA.
Current Problems in Diagnostic Radiology
|October 30, 1998
Summary
Percutaneous breast biopsy offers histologic diagnoses for nonpalpable lesions, revolutionizing breast imaging. Careful patient and lesion selection, alongside technical considerations, ensure optimal biopsy outcomes and patient care.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Percutaneous needle biopsy has transformed breast imaging by enabling histologic diagnosis of nonpalpable lesions.
- Radiologists performing these biopsies manage patient selection, procedure performance, result interpretation, and follow-up.
- Evolving biopsy techniques necessitate careful consideration of patient and lesion selection for optimal outcomes.
Purpose of the Study:
- To review the technical and interpretative aspects of percutaneous breast biopsy and needle localization for surgical biopsy.
- To highlight critical considerations for patient and lesion selection in percutaneous breast procedures.
- To discuss the advantages and limitations of various breast biopsy techniques.
Main Methods:
- Review of percutaneous breast biopsy techniques, including core biopsy and fine-needle aspiration biopsy (FNAB).
- Discussion of imaging guidance modalities (mammography, sonography) for nonpalpable lesion localization.
- Emphasis on radiologist's role in lesion selection, biopsy performance, and interpretation.
Main Results:
- Percutaneous biopsy is advantageous for diagnosing multicentric breast cancer, offering a less invasive and costly alternative to surgical biopsy.
- Certain lesions, like architectural distortion or specific microcalcifications, are better treated by excision.
- Imaging-guided localization is crucial for precise needle placement in nonpalpable lesions.
Conclusions:
- Percutaneous breast biopsy is a powerful tool, but careful selection of patients and lesions is paramount.
- Technical considerations and operator skill significantly impact biopsy success.
- Accurate preoperative needle localization aids surgeons, ensuring efficient procedures and optimal cosmetic results.