Review Article| Volume 25, ISSUE 4, P655-678, December 2005

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Image-Directed Fine Needle Aspiration Biopsy in Nonpalpable Breast Lesions

      The last few decades have seen the development of technology that allows detection of nonpalpable breast cancer. Screening mammography, ultrasound (US), and MRI are sensitive in varying degrees, but nonspecific in this task. Only 10% to 35% of nonpalpable lesions that are suspicious on mammography prove to be cancer at biopsy [
      • Shaw de Paredes E.
      Atlas of film-screen mammography.
      • Schwartz G.
      • Feig S.
      • Patchefsky A.
      Significance and staging of nonpalpable carcinomas of the breast.
      ]. Thus percutaneous methods to biopsy nonpalpable breast lesions are required, both for surgical and nonsurgical treatment planning for cancers, as well as to diagnose benign lesions so that surgical excision may be avoided. Percutaneous sampling of nonpalpable breast lesions permits relatively inexpensive tissue diagnosis while minimizing scarring, and allows optimal cosmesis after breast conservation surgery. It can be done with the guidance of US, stereotaxis, or MRI. This article discusses the use of fine needle aspiration biopsy (FNAB), and describe its strengths and limitations compared with other currently used biopsy needles.
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