Author Affiliations: Departments of Radiology (Drs Meyer, Smith, DiPiro, Denison, Harvey, Selland, and Durfee), Surgery (Drs Kaelin and Christian), and Pathology (Dr Lester), Brigham and Women's Hospital, Boston, Mass.
Context An increasing number of nonpalpable abnormalities
requiring breast biopsy are being identified due to the widespread use
of screening mammography. Large-core needle biopsy (LCNB) has become an
alternative to surgical excision.
Objective To determine whether LCNB is a safe and accurate
technique to evaluate nonpalpable abnormalities found on breast imaging
Design and Setting Case series at an institutional referral center
from August 1, 1991, to December 31, 1997.
Patients A total of 1643 women with 1 or more suspicious breast
abnormalities received LCNBs (n=1836 lesions).
Intervention The LCNB of the breast uses a 14- or 11-gauge needle
with stereotactic localization or ultrasound guidance.
Main Outcome Measure Utility and potential limitations of LCNB
compared with the criterion standard, surgical excision after wire
Results Of the 1836 breast lesions sampled, 444 (24%) were found
to be malignant. A total of 412 (22%) were found to be malignant on
the initial LCNB and 202 repeat biopsies yielded 32 additional
malignancies. Complications were infrequent: 1 patient experienced a
superficial infection and 1 developed a pneumothorax after LCNB.
Conclusion Image-guided LCNB is a reliable diagnostic alternative
to surgical excision of suspicious nonpalpable breast
Meyer JE, Smith DN, Lester SC, Kaelin C, DiPiro PJ, Denison CM, Christian RL, Harvey SC, Selland DG, Durfee SM. Large-Core Needle Biopsy of Nonpalpable Breast Lesions. JAMA. 1999;281(17):1638-1641. doi:10.1001/jama.281.17.1638