Rebiopsy after Stereotactic Core-needle Breast Biopsy: Prospective Study

CY Lui,HS Lam, KF Tam, EPY Fung, LK Chan

Hong Kong J Radiol 2004;7:116-20

Objective: To review the indications for rebiopsy and subsequent pathology after stereotactic percutaneous core biopsy of breast lesions.

Patients and Methods: Stereotactic, 14-Gauge, core-needle biopsy was performed on 242 non-palpable breast lesions in 240 consecutive patients from 1 January 2001 to 31 December 2002. The patients were followed up for 7 months to 2 years.

Results: Of the 242 breast lesions, 22 (9.1%) lesions required rebiopsy. Of these 22 cases, 14 (64%) were initially diagnosed to be atypical ductal hyperplasia; at rebiopsy, 6 were actually ductal carcinoma in situ. For 4 (18%), findings from mammographic and pathological examinations differed; 2 cases subsequently showed ductal carcinoma in situ. Two (9%) lesions underwent rebiopsy because of insufficient biopsy material; the final diagnosis for both was also ductal carcinoma in situ. For 1 (5%) lesion, the pathological diagnosis was upgraded from atypical lobular hyperplasia to lobular carcinoma in situ. For 1 (5%) lesion, mammography after the first biopsy showed an increased extent of calcification, although both biopsies showed fibrocystic change. Wire-guided excisional rebiopsy was performed in 18 (82%) cases; the remainder were stereotactic vacuumassisted rebiopsies. Rebiopsy showed 11 (50%) upgrades of histological diagnosis and 10 (45%) cases of malignancy.

Conclusions: Patients should be informed of the possibility of rebiopsy, and radiologists or surgeons should initiate a rebiopsy if histological and mammographic findings disagree; if a lesion is heterogeneous or a papillary lesion, radial scar, or possible phylloides tumour; or if material is insufficient for a pathological diagnosis to be made.