Stereotactic Core Breast Biopsy Research Articles

Video-Based Teaching of Image-Guided Breast Interventions: Stereotactic Core Biopsy Using a Prone Table.

The introduction of new technologies and teaching strategies to educate the digital learner creates the potential for a better and more standardized training experience across programs. Thus, we sought to create an instructional video on stereotactic core breast biopsy that simulates best practices and could be readily accessed by training programs to improve and standardize resident education. At our institution, we use the video and questions as part of a flipped classroom educational activity. Residents are requested to complete the questions at home and watch the video. They then take the posttest questions during the lecture period, at which time the answers are reviewed and there is additional discussion of the procedure. The tests contain both video-related questions and control questions. After viewing the video, there was a 30% mean improvement in the video-related questions compared to a 0% improvement in the control set of questions. An instructional video on stereotactic core biopsy was created with associated assessment questions that can be used at any institution for the purposes of improving and standardizing training in breast imaging procedures. This resource can be especially useful for programs where trainees have limited procedure exposure.

Comparison of stereotactic core breast biopsy and open surgical biopsy results at a tertiary care hospital in Pakistan

BackgroundThe purpose of this study was to determine the yield of stereotactic core breast biopsy and its cost-saving potential.MethodsThis observational study was conducted at the Department of Radiology at Aga Khan Hospital in Karachi. All female patients (n = 84) undergoing stereotactic core breast biopsy under mammographic guidance from January 2005 to May 2010 were included. Stereotactic core biopsy was performed on a dedicated mammography unit employing a 14-gauge needle with an automated biopsy device. Ten patients with incomplete medical records were excluded. All breast biopsy results were either compared with surgical findings in cases of malignant histopathological findings or with follow-up needle localization in case of benign core biopsy findings.ResultsFifteen of our 74 patients had malignant findings on stereotactic biopsy, confirmed on histopathology of the final surgical mastectomy specimen. The remaining 59 patients had benign results on histopathology; five patients had needle localization of the same area due to either suspicious mammographic findings or clinical suspicion of malignancy. All were proven to be histopathologically benign on open surgical biopsy. Fifty-four patients with benign results had follow-up mammograms, and the follow-up period was 18 months to 5 years. The sensitivity and specificity was 100%. The cost saving per patient was US$253.ConclusionStereotactic core breast biopsy is a safe and cost-effective method for determining the nature of suspicious mammographic findings.

Educational Intervention for Women Undergoing Image-Guided Breast Biopsy: Results of a Randomized Clinical Trial

The process of informed consent has been examined for patients undergoing various procedures but not breast biopsy. Our study was a randomized trial that examined the effect of an educational flip chart as part of the informed consent. A total of 122 patients referred for stereotactic or ultrasound-guided core breast biopsy were randomly assigned to receive an informed consent discussion with or without an illustrated flip chart. The chart included information about breast anatomy, pathology, and diagnostic procedures. Outcome measures included objective knowledge, subjective knowledge, anxiety, and satisfaction. Analysis showed few significant main effects of the intervention. However, results showed interactions between experimental condition and race/ethnicity, indicating that the intervention was effective in enhancing objective and subjective knowledge for African American but not Caucasian patients. Anxiety after consultation was higher among patients assigned to the flip chart condition, possibly because they were better informed about the risks of the procedure. Patients who underwent biopsy sooner after learning they needed one were more satisfied with their care. The usual care consent process is effective for many but not all patients. Informed consent that employs visual aids may help overcome characteristics of the consent process that are ineffective for some patients.

Does Therapeutic Touch Ease the Discomfort or Distress of Patients Undergoing Stereotactic Core Breast Biopsy? A Randomized Clinical Trial

To determine whether therapeutic touch administered at the time of stereotactic core biopsy of suspicious breast lesions results in a reduction in anxiety and pain. Randomized, patient-blinded, controlled trial of either Krieger-Kunz therapeutic touch administered by a trained practitioner or a sham intervention mimicking therapeutic touch delivered during core biopsy. Stereotactic breast biopsy unit of a comprehensive breast center. Women with mammographically detected, nonpalpable breast lesions requiring biopsy. Changes in pain and anxiety measured by visual analog scales immediately before and after stereotactic core biopsy. A total of 82 patients were accrued: 42 received actual therapeutic touch and 40 sham therapeutic touch. No significant differences were found between the arms for age, ethnicity, educational background, or other demographic data. The sham arm had a preponderance of left breast biopsies (48% vs 58%; P = 0.07) and received a slightly higher volume of epinephrine-containing local anesthetic (6.5 +/- 6.1 vs 4.5 +/- 4.5 mL; P = 0.09). Therapeutic touch patients were more likely to have an upper breast lesion location (57% vs 53%; P = 0.022). No significant differences between the arms were seen regarding postbiopsy pain (P = 0.95), anxiety (P = 0.66), fearfulness, or physiological parameters. Similarly, no differences were seen between the arms when change in parameters from prebiopsy to postbiopsy was considered for any of the psychological or physiological variables measured. These findings persisted when confounding variables were controlled for. Women undergoing stereotactic core breast biopsy received no significant benefit from therapeutic touch administered during the procedure. Therapeutic touch cannot be routinely recommended for patients in this setting.

Breast Microcalcifications: Retrieval Failure at Prone Stereotactic Core and Vacuum Breast Biopsy—Frequency, Causes, and Outcome

Breast Microcalcifications: Retrieval Failure at Prone Stereotactic Core and Vacuum Breast Biopsy—Frequency, Causes, and Outcome

4–14 Breast Microcalcifications: Retrieval Failure at Prone Stereotactic Core and Vacuum Breast Biopsy—Frequency, Causes, and Outcome

4–14 Breast Microcalcifications: Retrieval Failure at Prone Stereotactic Core and Vacuum Breast Biopsy—Frequency, Causes, and Outcome

Follow-up of benign results of stereotactic core breast biopsy

The purpose of this study was to obtain long-term follow-up data on women with benign histologic results of a breast stereotactic core needle biopsy (CNB). Mammography charts of 300 consecutive women who underwent prone stereotactic CNB with digital radiography were reviewed. Women with frankly malignant or suspicious histologic findings (51 patients) or a technically unsuccessful stereotactic CNB (one patient) were excluded. The remaining 248 benign core biopsies in 229 women were included in the study. Follow-up mammograms were obtained for 152 lesions with benign histologic results following stereotactic CNB. The mean length of follow-up after stereotactic CNB was 34.6 months. Cancer was diagnosed in six women who underwent surgical biopsies 1/2 to 30 months after benign stereotactic CNB. An initial chart review demonstrated that no follow-up data were available for 64 lesions, and information was missing for an additional seven. SCNB remains a sampling procedure that can result in false-negative histologic results. Intrinsic procedural issues were identified that could minimize the potential for missing a malignancy. Goals for patient compliance with follow-up recommendations fell short of expectations.

Probably benign breast lesions: when should follow-up be recommended and what is the optimal follow-up protocol?

Probably benign breast lesions: when should follow-up be recommended and what is the optimal follow-up protocol?

The Role of Stereotactic Biopsy in Abnormal Mammograms

Core needle biopsy using either stereotactic or ultrasonographic guidance is a reasonable and accurate alternative to surgical biopsy for diagnosis of most nonpalpable breast lesions. An important component of a stereotactic core breast biopsy procedure is the mammographic and pathologic correlation of findings to plan optimal patient management. The level of suspicion of a mammographic lesion, the accuracy of stereotactic targeting, and the confirmation of microcalcifications in specimen radiographs for calcified lesions must be considered carefully and correlated with the histopathologic findings. Meticulous operator technique is essential to provide representative samples of the mammographic abnormality. Properly performed, imaging-guided percutaneous core breast biopsy has reduced the morbidity of surgical breast biopsy and the overall cost of breast cancer diagnosis. Recent work has demonstrated that stereotactic core breast biopsy can reduce the cost of diagnosing mammographically detected breast lesions by more than 50%. At a time when health-care policy and reimbursement decisions are influenced by cost considerations, increased use of stereotactic core breast biopsy is anticipated. Meticulous attention to technique allows maximal realization of the benefits of this procedure.

Analysis of cancers not diagnosed at stereotactic core breast biopsy.

To evaluate the mammographic and histopathologic features of carcinomas not diagnosed at stereotactic core biopsy. A retrospective review revealed 144 surgically confirmed carcinomas preoperatively sampled with stereotactic core biopsy. Diagnosis at stereotactic core biopsy was carcinoma in 116 (81%) lesions, atypical hyperplasia in 21 (15%), and benign findings discordant with those from mammography in seven (5%). Mammographic and histopathologic findings in the latter 28 cases were reviewed. Prompt repeat biopsy was recommended in all 28 cases. The frequency with which a cancer yielded atypical hyperplasia at stereotactic core biopsy was higher for calcifications than masses (30% vs 5%, P < .0001), ductal carcinoma in situ (DCIS) than infiltrating carcinoma (33% vs 7%, P = .0002), and noncomedo than comedo DCIS (60% vs 9%, P = .0008). No significant difference was observed in the likelihood of benign core biopsy findings without atypia in malignant calcifications versus masses (7% vs 3%, P = .43), DCIS versus infiltrating carcinoma (7% vs 4%, P = .43), or noncomedo versus comedo DCIS (0% vs 9%, P = .49). The likelihood of not diagnosing carcinoma was highest for calcifications and for noncomedo DCIS. Discordance in mammographic and histopathologic findings or the presence of atypical hyperplasia may enable the radiologist to identify missed or underestimated carcinomas prospectively and avoid a delay in diagnosis.

Stereotactic core breast biopsy versus needle localization breast biopsy - the effect of initial diagnostic modality on surgical therapy in patients with breast cancer

Summary. The aim was to assess the effect of the initial diagnostic modality on surgical planning in patients with mammographically detected malignancies. A retrospective chart review of 40 patients with mammographically detected breast cancer was undertaken. The diagnosis was established in 20 patients by needle localization breast biopsy and in 20 patients by stereotactic core breast biopsy. In patients whose diagnosis was established by stereotactic core breast biopsy, all were treated with only one operation per patient. In those patients whose diagnosis was established by needle localization breast biopsy, an average of 2.1 surgeries per patient were required to diagnose and treat this group. Patients with abnormal mammograms should have the diagnosis established by stereotactic biopsy. If the lesion was malignant, a planned one-stage definitive operation was successful in all of our patients. We feel that stereotactic core biopsy is the preferred method for establishing a diagnosis in patients with suspicious mammographic findings.

The current state of stereotactic core breast biopsy and mammotomy

SummaryThe ‘standard’ stereotactic core biopsy technique represents a stable plateau in the evolution of percutaneous breast intervention. In the spring of 1993, a purpose-built stereotactic breast biopsy instrument, the Mammotomer` (Biopsysr` Medical, Inc., Irvine, CA) was developed. The stereotactic ‘mammotomy’ procedure allows the sampling probe to remain in the breast during the entire biopsy procedure, while tissue samples are automatically deposited into a ‘pathology cassette’ for tissue position coding and histologic processing. This technique improves accuracy and has replaced mammographic localization and open surgical biopsy at our institution. The classic breast diagnostic and therapeutic referral patterns involving the general surgeon, radiologist and patient are reviewed. Percutaneous breast cancer treatment methods are also discussed.

62. ステレオ乳房生検装置MammotestおよびMammo Visionの性能評価

62. ステレオ乳房生検装置MammotestおよびMammo Visionの性能評価

The role of core biopsy in the diagnosis of mammographically detected lesions.

Both stereotactic imaging and ultrasound have been used to localize non-palpable breast lesions for core biopsy analysis. In particular, stereotactic core breast biopsy with a dedicated recumbent mammographic unit is an accurate and reliable technique, and this has been substantiated in a number of recent prospective studies comparing percutaneous core biopsy with open excisional biopsy. This article reviews biopsies of 521 lesions from 502 cases using both stereotactic localization (469 lesions) and ultrasound (33 lesions). The types of breast cancer and benign breast disease diagnosed with core sampling are reviewed. In this series it was not intended to compare all the results of core biopsies with those of open excisional biopsy, but a subset group, which comprised certain benign lesions and malignancies, as well as lesions diagnosed on core biopsy in which the radiology and pathology did not correlate, was further evaluated and compared to the findings with open biopsy. The cases where there were differences in core and excisional biopsy diagnosis are discussed. In this series the benign to malignant ratio was 2.7:1, in other words, 27% of the lesions biopsied were malignant. The sensitivity for detecting cancer was 97% with the positive predictive value being 99%. This series further substantiates the accuracy of core biopsy. It is recommended that certain lesions diagnosed as benign on core biopsy histology should also proceed to open biopsy. Correlation between clinical findings, radiology and pathology further improves the reliability of core biopsy under imaging guidance.

62.ステレオ乳房生検装置MammotestおよびMammoVisionの性能と臨床評価(第24回秋季学術大会 一般研究発表予稿集)

62.ステレオ乳房生検装置MammotestおよびMammoVisionの性能と臨床評価(第24回秋季学術大会 一般研究発表予稿集)