What is the role of stereotactic wide-bore needle biopsy in the workup of breast lesions?

Updated: Aug 09, 2018
  • Author: Hemant Singhal, MD, MBBS, MBA, FRCS, FRCS(Edin), FRCSC; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Answer

Answer

A Tru-Cut needle, ideally 14-gauge, is used for core biopsy. Because of the fibrous nature of much breast tissue, adequate samples are best obtained using a spring-loaded firing device, such as the Biopty-Cut system. The procedure is often less painful than FNA despite the wider-bore needle.

After subcutaneous injection of local anesthetic, cores of tissue can be taken and should be fixed immediately in formalin. If the lesion contains calcification based on the mammogram findings, radiographs of the cores are taken to confirm the presence of calcification and that the cores are representative. The risk of bruising with wide-bore needle biopsies is higher than with FNA. For this reason, anticoagulants should be stopped, when possible, before biopsy and a pressure dressing is applied, usually for at least 24 hours.

Often, the samples are large enough to allow detailed histologic assessment, including tumor type and grade and hormone receptor status, but sampling error may occur if the cores are not representative of the entire lesion.


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