Large-Gauge Core Needle Biopsy of the Breast

Abstract: Large-gauge core needle biopsy (LGCNB) of the breast is gaining acceptance as a viable alternative to surgical excision. The procedure can be performed efficiently using ultrasound or stereotactic guidance. We report our experience with 137 LGCNB performed over a 40-month period. One hundred thirty-seven lesions in 125 patients were subjected to LGCNB. Fifty-nine procedures were performed using stereotactic guidance and 78 using ultrasound guidance. Stereotactic procedures utilized a prone table and ultrasound procedures used a freehand technique. All biopsies were performed with a 14-gauge core needle attached to an automated biopsy device. There were 53 malignant and 84 benign diagnoses in this group of 137 LGCNB. Surgical correlation is available in 46 of the 53 malignant cases. There were no false positives, though one lesion was missed at the initial surgical excision but retrieved at reexcision. Of the 84 benign cases, there has been surgical (n = 10) or mammographic follow-up (n = 32) in 42. The mean duration of mammographic follow-up is 13 months (range: 5–36 months). There was one false negative LGCNB. The sensitivity, specificity, positive predictive value, and negative predictive value in this series are 98%, 100%, 100% and 96%, respectively. LGCNB has a high degree of accuracy and is well accepted by patients. There are some persistent difficulties with the technique, such as ensuring compliance with follow-up recommendations among patients with benign results and excluding invasive carcinoma.?