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US-guided core needle biopsy: False-negatives. How to reduce them?

2012; Elsevier BV; Volume: 82; Issue: 3 Linguagem: Inglês

10.1016/j.ejrad.2012.03.003

1872-7727

Nicolas Perrot, Aurélie Jalaguier-Coudray, Isabelle Frey, Isabelle Thomassin‐Naggara, J. Chopier,

Cancer and Skin Lesions

Breast cancer is a major cause of suffering and death and is of significant concern to many women. Early systematic mammographic screening can detect breast cancers which are more amenable to effective therapy and generally more favorable for quality of life. Open excision biopsies have increasingly been replaced by preoperative diagnostic techniques such as needle aspiration cytology, and more commonly, core biopsies. Preoperative core biopsy is becoming the standard of care in breast cancer. Many institutions have chosen core biopsy as a preoperative diagnostic tool in breast disease in an attempt to increase diagnostic sensitivity, determine the type and invasive nature of the disease and avoid unnecessary operations [ 1 Fuhrman G.M. Cederbom G.J. Bolton J.S. et al. Image-guided core-needle breast biopsy is an accurate technique to evaluate patients with nonpalpable imaging abnormalities. Ann Surg. 1998; 227: 932-939 Crossref PubMed Scopus (110) Google Scholar , 2 Verkooijen H.M. Borel Rinkes I.H. Peeters P.H. et al. Impact of stereotactic large-core needle biopsy on diagnosis and surgical treatment of nonpalpable breast cancer. Eur J Surg Oncol. 2001; 27: 244-249 Abstract Full Text PDF PubMed Scopus (47) Google Scholar , 3 Verkooijen H.M. Peeters P.H. Pijnappel R.M. Koot V.C. Schipper M.E. Borel Rinkes I.H. Diagnostic accuracy of needle-localized open breast biopsy for impalpable breast disease. Br J Surg. 2000; 87: 344-347 Crossref PubMed Scopus (35) Google Scholar , 4 March D.E. Raslavicus A. Coughlin B.F. Klein S.V. Makari-Judson G. Use of breast core biopsy in the United States: results of a national survey. AJR Am J Roentgenol. 1997; 169: 697-701 Crossref PubMed Scopus (45) Google Scholar ]. Percutaneous image-guided core needle biopsy is performed under either stereotactic or ultrasound (US) guidance. US guidance offers a number of advantages over stereotactic guidance. It is performed in real time, and direct needle visualization with ultrasound allows an accurate assessment of sampling. The procedure is quicker, causes less patient discomfort and does not involve ionizing radiation. The possibility of "missing" or delaying the diagnosis of breast cancer, as a result of a falsely-reassuring benign biopsy, is an outcome that every clinician endeavors to avoid.