Breast Biopsy Methods

Breast Biopsy - Which Method is Better

What is the problem and what is known about it so far?
The routine use of mammography has increased the number of cancerous and non-cancerous breast abnormalities found in women. These abnormalities often require further evaluation with a biopsy. Biopsies can be performed either surgically or by needle. As the majority of breast biopsies end up being not cancerous, it would be preferable to avoid invasive surgery.

Why did the authors do this review?
The purpose of this article was to discuss the indications, advantages and applications of new image-guided techniques for breast biopsies in order to improve patient care and prevent unnecessary invasive breast surgery.

How did the authors do this review?
The authors evaluated published literature and summarized the techniques of minimally invasive breast biopsy procedures.

What did the authors find?
The authors found that needle biopsy using ultrasound was the procedure of choice for diagnosing breast abnormalities because of ease, patient comfort, avoidance of radiation, and the ability to perform the procedure in the doctor’s office. Of the two techniques of needle biopsy: fine needle aspiration and core needle biopsy, the latter is preferred. Core needle biopsy is superior because it has the ability to provide more detailed information about the type of cancer which helps to better direct treatment. However, for breast abnormalities seen only on mammogram, stereotactic-guided breast biopsy (a biopsy performed using mammogram images) is best. The drawback to stereotactic biopsy includes the need for mammography, and uncomfortable patient positioning on a special table.  Both ultrasound-guided and stereotactic biopsy techniques are more advantageous than open surgical biopsy.

What are the implications of the review?
This review suggests that whenever possible, patients found with a breast abnormality needing biopsy should undergo ultrasound-guided core needle biopsy because it is safe, minimally invasive, and gives accurate diagnosis.

Summarized by Talia K. Ben-Jacob, College of Medicine, University of Vermont.
Summarized from "Image-guided breast surgery."  Nurko J, Edwards M., American Journal of Surgery, October 2005, Volume 190, Number 4, Pages 221-227.