Stereotaxic percutaneous core biopsy versus surgical biopsy of nonpalpable breast lesions using a standard mammographic table with an add-on device.

OBJECTIVE: To determine the accuracy of using a regular mammographic table with an add-on device for biopsy of nonpalpable breast lesions in women in a community hospital setting. PATIENTS AND METHODS: During a 3-year period, 70 consenting women (39-80 years of age) with a nonpalpable mammographically suspicious lesion on routine screening mammography underwent 14-gauge automated percutaneous core biopsies, immediate needle localization and lumpectomy. The needle and surgical biopsy results were independently classified into 1 of 5 categories: cancer, fibroadenoma, fibrocystic change, normal or other. RESULTS: The procedure was well tolerated, and all core specimens yielded adequate tissue for pathologic evaluation. There were 3 episodes of vasovagal reaction. There was complete agreement in histologic findings in 64 cases (91%), including 22 of 24 cancers (92%). The overall agreement for categorizing lesions was 91% (kappa = 0.88), and there was 97% agreement (kappa = 0.94) for the classification of cancer versus benign lesion. CONCLUSION: The results are similar to those of studies performed with dedicated prone equipment. Stereotaxic core biopsies can be done safely and accurately in a community hospital setting with relatively inexpensive nondedicated mammographic equipment.