Breast Biopsy: A Pathologist’s Perspective on Biopsy Acquisition Techniques and Devices with Mammographic–Pathologic Correlation

An effective breast biopsy team requires detailed communication, particularly between radiologists and pathologists, to achieve the most accurate and useful diagnostic information from each minimally invasive breast biopsy procedure. A number of different biopsy devices are available and lend themselves to different imaging and clinical situations. The effect of biopsy size and number of biopsy fragments on diagnostic accuracy is discussed, with particular emphasis on biopsies directed at calcifications. In this context, differentiation of atypical hyperplasias from low-grade ductal carcinoma in situ depends not only on accurate targeting but also sufficient biopsy size. Some of the commonly used image-directed biopsy devices and site marking techniques are listed. Regular radiology–pathology correlation conferences foster collegial understanding of the strengths and limitations of each other’s analytical techniques and can lead to better patient care.