Abstract
• Nonoperative diagnosis should become the norm in breast disease assessment. The aim of sampling procedures should be to fulfil the “triple diagnostic assessment” and achieve as near as possible 100 % nonoperative diagnosis of breast problems. • Automated core needle biopsy (CNB) is the sampling technique of first choice, to prefer over fine needle aspiration (FNA) because of fewer inadequate samples. In most cases, CNB accomplishes the same results of an open incisional biopsy. • Ultrasound guidance, if feasible, is the technique of first choice for biopsy of both palpable and impalpable breast lesions; it is less costly, easy to perform and more accurate than free-hand or other image-guided techniques. • Management of high-risk lesions remains controversial. The likelihood of atypical ductal hyperplasia or radial scar in association with BC is related to the size of the lesion and the age of the patient.
Future directions. Percutaneous image-guided biopsies are increasingly an alternative to surgical biopsy for the histological assessment of breast lesions. Moreover, in BC and in some borderline lesions, core needle samples are becoming larger in order to provide a complete set of prognostic factors to guide the decision-making process and to enable new strategies of treatment.
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Further Reading
Ciatto S. B3 core biopsies should be assumed as positive findings for accuracy purposes. Radiol Med. 2011;116:982–3.
Nakano S, Otsuka M, Mibu A, Oinuma T. Significance of fine needle aspiration cytology and vacuum-assisted core needle biopsy for small breast lesions. Clin Breast Cancer. 2015;15:e23–6.
Parkin CKE, Garewal S, Waugh P, Maxwell AJ. Outcomes of patients with lobular in situ neoplasia of the breast: the role of vacuum-assisted biopsy. Breast. 2014;23:651–5.
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Saguatti, G., Dell’Oste, G., Teggi, S. (2015). Breast Tissue Diagnosis. In: Pluchinotta, A. (eds) The Outpatient Breast Clinic. Springer, Cham. https://doi.org/10.1007/978-3-319-15907-2_6
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DOI: https://doi.org/10.1007/978-3-319-15907-2_6
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