Comparison of preoperative simultaneous stereotactic fine needle aspiration biopsy and stereotactic core needle biopsy in ductal carcinoma in situ of the breast

PURPOSE: To compare the preoperative results of stereotactic fine needle aspiration biopsy (S-FNAB) with stereotactic core needle biopsy (S-CNB) performed simultaneously in breast lesions with the postoperative histopathological diagnosis of ductal carcinoma in situ (DCIS) of all histological grades. MATERIAL AND METHODS: 733 consecutive stereotactic biopsies were performed between May 1993 and June 1999. In 72 patients with mammographic findings suspicious of malignancy who were subjected to breast surgery, postoperative histopathology showed DCIS. Preoperatively, S-FNAB and S-CNB had been done simultaneously in all patients, S-FNAB with spinal needle 0.7 or 0.9 mm and S-CNB was performed with an automated 2.1-mm biopsy gun. An average of 3 S-FNABs and 3 S-CNBs were performed in each patient. RESULTS: In 56 (78%) of the 72 patients S-CNB showed DCIS. In 3 patients (4%) the S-CNB revealed "probable carcinoma", in 7 patients (10%) "atypia" and in 6, the lesions were benign. In 34 (47%) of the 72 women S-FNABs showed carcinoma, not otherwise specified. In 6 cases (8%) the S-FNABs showed "probable carcinoma" and in 12 patients (17%) "atypia"; 8 lesions were benign and 12 not diagnostic. CONCLUSION: S-CNB was superior to S-FNAB in diagnosing DCIS. Only 6 patients (8%) received a benign or non-diagnostic preoperative diagnosis with S-CNB compared to 20 patients (28%) with S-FNAB. S-CNB was superior to S-FNAB for preoperative diagnosis of DCIS, but S-FNAB could further increase the sensitivity of the biopsy since it diagnosed cancer in 4 cases where S-CNB showed benign material.