Automated Stereotaxic Core Needle Biopsy of Breast Lesions

To assess the feasibility of automated stereotaxic core needle biopsy (SCNB) on breast lesions, 26 cases of mammographically suspected breast lesions that underwent SCNB were retrospectively studied. SCNB was restricted to patients with suspect breast lesions presented as microcalcification (15 cases), nodular density with calcification (7 cases), spiculated mass with microcalcification (2 cases), nodule (1 case) or architectural distortion (1 case) on mammograms. None of the suspected lesions were cystic on sonograms. According to the Breast Imaging Reporting and Data System (BI-RADS) developed by American College of Radiology, the lesions on mammograms were classified as probably benign lesions (BI-RADS category 3) in 2 cases, low-to-intermediate lesions (BI-RADS category 4) in 15, and highly suspect for malignancy (BIRADS category 5)in 9. SCNB was performed on all patients. The number of specimens obtained from each lesion ranged from 4 to 10 (mean 5). Magnification radiography was used to evaluate calcification in specimen. The pathological examination of specimens from SCNB revealed benign lesions in 12 patients (fibroadenoma in 5, fibrocystic change 4, fibrosis with calcification 2, and adenosis in one), normal breast tissue in 7, and breast carcinoma in 7. All the lesions classified as BI-RADS category 3 or 4 were proved to be benign by SCNB, while 78% (7 of 9) of lesions shown as BI-RADS category 5 on mammograms were proved to be malignant by SCNB. Of 24 cases with calcification on mammograms, 14 (58%) revealed calcification on specimen radiographs. One patient with calcified fibroadenoma had a complication of bending of biopsy needle during the SCNB procedure causing failure of needle withdrawal. In conclusion, SCNB is an efficient and safe alternative in obtaining sufficient tissues for diagnosing breast lesions. It may spare some selected patients a surgical biopsy procedure. One should avoid directly targeting a densely calcified nodule.