Coaxial core needle biopsy under mammographic guidance: indications and applications

Diagnostic accuracy of perforated compression grid approach for mammographically guided core needle biopsy of breast lesions

The aim of this study was to evaluate the diagnostic accuracy of large core breast biopsy with the use of the perforated compression grid (PCG) in a series of 106 consecutive mammographically detected breast lesions. The PCG consists in a fenestrated paddle that replaces the usual mammographic compressor. Each hole in the grid is marked by letters and numbers in order to obtain the coordinates of the area to biopsy. By analysing the two orthogonal projections, the depth of the lesion in the breast is calculated. With the breast positioned in the PCG, a skin incision is made. After calculations about the depth of needle insertion, the tip of the needle is inserted proximally to the target area. In such a way, taking into consideration the total running of the needle (23 mm), a correct sampling is assured, and multiple needle passes are performed. Sensitivity was of 90.62 and 90.90%, specificity was of 100 and 95.45% and positive predictive value was of 100 and 90.90% by excluding and including suspicious diagnoses, respectively, for each computation. In conclusion, the study indicated that image-guided core biopsy performed by the approach of PCG is a cost-effective, simple and accurate technique for the diagnosis of breast lesions, and it could be proposed as a low-cost alternative where the stereotactic equipment is not available.