Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging

• DOI: 10.1186/s13244-019-0803-x
• Publication Date: 2020-02-05T12:02:44Z
• Authors: Ulrich Bick; Rubina M. Trimboli; Alexandra Athanasiou; Corinne Balleyguier; Pascal A. T. Baltzer; Maria Bernathova; Krisztina Borbély; Boris Brkljacic; Luca A. Carbonaro; Paola Clauser; Enrico Cassano; Catherine Colin; Gul Esen; Andrew Evans; Eva M. Fallenberg; Michael H. Fuchsj...; Fiona J. Gilbert; Thomas H. Helbich; Sylvia H. Heywang...; Michel Herranz; Karen Kinkel; Fleur Kilburn-Toppin; Christiane K. Kuhl; Mihai Lesaru; Marc B. I. Lobbes; Ritse M. Mann; Laura Martincich; Pietro Panizza; Federica Pediconi; Ruud M. Pijnappel; Katja Pinker; Simone Schiaffino; Tamar Sella; Isabelle Thomassi...; Anne Tardivon; Chantal Van Ongeval; Matthew G. Wallis; Sophia Zackrisson; Gabor Forrai; Julia Camps Herrero; Francesco Sardanelli
• Keywords: WIRE LOCALIZATION; CORE-NEEDLE-BIOPSY; Radboudumc 17: Women's cancers RIHS: Radboud Institute for Health Sciences; R895-920; 610; Radboud University Medical Center; Guideline; 2ND-LOOK ULTRASOUND; /dk/atira/pure/subjectarea/asjc/2700/2741; Medical physics. Medical radiology. Nuclear medicine; 03 medical and health sciences; 0302 clinical medicine; Breast Lesion Localisation; Breast lesion localisation; breast biopsy, imaging; 616; Medical Imaging - Radboud University Medical Center; Fine-needle sampling; MALIGNANT POTENTIAL B3; EUSOBI RECOMMENDATIONS; DIAGNOSTIC-ACCURACY; Breast; Fine-needle Sampling; ASPIRATION-CYTOLOGY; Science & Technology; Radiology, Nuclear Medicine & Medical Imaging; RADIOACTIVE SEED LOCALIZATION; 3. Good health; Breast; percutaneous biopsy; imaging guidance; mammography; tomosynthesis; magnetic resonance imaging; LYMPH-NODE BIOPSY; Vacuum-assisted biopsy; Core Needle Biopsy; name=Radiology Nuclear Medicine and imaging; Breast; Breast lesion localisation; Core needle biopsy; Fine-needle sampling; Vacuum-assisted biopsy; LESION EXCISION SYSTEM; Core needle biopsy; Life Sciences & Biomedicine; Vacuum-assisted Biopsy

AbstractWe summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriate combination of device type for sampling and imaging technique for guidance. Then, we describe the commonly used devices, from fine-needle sampling to tissue biopsy with larger needles, namely core needle biopsy and vacuum-assisted biopsy, and how mammography, digital breast tomosynthesis, ultrasound, or magnetic resonance imaging work for targeting the lesion for sampling or localisation. The differences among the techniques available for localisation (carbon marking, metallic wire, radiotracer injection, radioactive seed, and magnetic seed localisation) are illustrated. Type and rate of possible complications are described and the issue of concomitant antiplatelet or anticoagulant therapy is also addressed. The importance of pathological-radiological correlation is highlighted: when evaluating the results of any needle sampling, the radiologist must check the concordance between the cytology/pathology report of the sample and the radiological appearance of the biopsied lesion. We recommend that special attention is paid to a proper and tactful approach when communicating to the woman the need for tissue sampling as well as the possibility of cancer diagnosis, repeat tissue sampling, and or even surgery when tissue sampling shows a lesion with uncertain malignant potential (also referred to as “high-risk” or B3 lesions). Finally, seven frequently asked questions are answered.