Sandra J. Shin - A Comprehensive Guide to Core Needle Biopsies of the Breast

A Comprehensive Guide to Core Needle Biopsies of the Breast — read online for free the complete book (whole text) full work

Below is the text of the book, divided by pages. System saving the place of the last page read, allows you to conveniently read the book "A Comprehensive Guide to Core Needle Biopsies of the Breast" online for free, without having to search again every time where you left off. Put a bookmark, and you can go to the page where you finished reading at any time.

Light

Font size:

↓

↑

Georgia Tahoma Arial Verdana

Reset

Interval:

↓

↑

Bookmark:

Make

1234567...261

Part I
The Core Needle Biopsy Program

Springer International Publishing Switzerland 2016

Sandra J. Shin (ed.) A Comprehensive Guide to Core Needle Biopsies of the Breast 10.1007/978-3-319-26291-8_1

1. Essential Components of a Successful Breast Core Needle Biopsy Program: Imaging Modalities, Sampling Techniques, Specimen Processing, Radiologic/Pathologic Correlation, and Appropriate Follow-Up

Christine M. Denison 1

(1)

Department of Radiology, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, USA

(2)

Department of Pathology, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, USA

Christine M. Denison

Email:

Susan C. Lester (Corresponding author)

Email:

Keywords

Breast core needle biopsies Quality assurance Best practices Radiologic/pathologic correlation Artifacts Core needle biopsy recurrence Correlation conference Pitfalls Specimen processing

Introduction

The ability to accurately sample and diagnose breast lesions without the need for surgery has major advantages for patients, radiologists, pathologists, surgeons, biomedical research, and the healthcare system:

Benefits to Patients

• The amount of tissue needed for diagnosis is minimized.
• The morbidity of a needle biopsy is less than that of a surgical excision.
• Fewer biopsy-related changes (e.g., scarring) that could complicate imaging follow-up are created.
• A definitive diagnosis is obtained in a short span of time.
• Women with benign findings are spared surgery.
• A core needle biopsy of malignancy aids in subsequent treatment planning.
• Multiple areas in both breasts can be sampled to determine optimal surgery.
• Patients who proceed initially with surgery are more likely to achieve the definitive excision of the breast cancer, with negative margins, and nodal evaluation in one procedure.
• Patients have the option to undergo treatment first (i.e., presurgical or neoadjuvant therapy). The clip placed at the time of the needle biopsy is essential to identify the tumor bed after treatment.
• Core needle biopsies obtained without the use of heating or freezing tissue obtain cancer samples with the optimal preservation of biomolecules for assays to determine therapy and prognosis.
• Women with lymphoma or metastatic malignancies are spared unnecessary surgery.

Benefits to Radiologists

• Lesions identified by imaging can be directly sampled to obtain optimal correlation with pathologic diagnosis.
• A specific diagnosis can aid in following patients with focal findings on breast imaging over time.
• Close correlation of radiologic findings with pathologic diagnoses increases the knowledge base of radiologists.

Benefits to Pathologists

• Smaller core needle specimens are easier to process and evaluate compared to excisional biopsies.
• There is greater certainty that the tissue being examined by the pathologist contains the lesion detected by imaging. In contrast, small lesions can be very difficult to identify with certainty in large excisional specimens and mastectomies.
• Close correlation of radiologic findings with pathologic diagnoses increases the knowledge base of pathologists.

Benefits to Surgeons

• Surgical planning is facilitated by the ability to evaluate multiple lesions by core needle biopsy.
• It is more likely that surgery of the breast and lymph nodes will be successful in one procedure when there is a definitive diagnosis of cancer on core needle biopsy.
• A clip placed at the time of diagnosis aids in localization of the tumor bed for breast-conserving therapy after neoadjuvant therapy.

Benefits for Biomedical Research

• A needle biopsy provides tissue with optimal preservation of biomolecules due to minimal ischemic time and the absence of damage due to heating or freezing of the tissueif the needle biopsy technique used only cutting needles for tissue removal.
• A definitive diagnosis of invasive carcinoma with determination of tumor markers on core needle biopsy provides sufficient information to evaluate patients prior to neoadjuvant therapy.
• Tumors can be sampled at multiple time points during treatment.

Benefits to the Medical Care System

• Needle biopsies reduce the cost of investigating breast lesions found by imaging.
• Women with benign findings do not require surgery or surgical follow-up.

A successful core needle biopsy program requires close communication among radiologists, pathologists, and surgeons and a basic understanding of the principles of all three disciplines by everyone involved [). In this chapter the information that pathologists need to know about breast imaging, biopsy processing, radiologic/pathologic correlation, and the surgical excision of lesions identified by core needle biopsy will be discussed, as well as the critical role of the pathologist in a core needle biopsy program.

Fig. 1.1

The numerous steps and multiple people involved in a core needle biopsy program ( left side ) creates the possibility for many types of errors ( right side ). Good communication as well as an understanding of the management issues in all three disciplines (pathology, radiology, and surgery), ensures that patients have an optimal outcome

Breast Imaging Modalities

The three modalities commonly used to evaluate the breast are mammography, ultrasound, and magnetic resonance imaging (MRI).

The American College of Radiologists has created standardized terminology for reporting imaging findings (the Breast Imaging Reporting and Data System or BI-RADS) (Table ]. The majority of lesions undergoing biopsy will be in the BI-RADS 35 categories.

Table 1.1

BI-RADS assessment categories

Assessment category	Clinical management	Likelihood of cancer
0: Incomplete	Additional imaging or comparison to prior images	Not applicable
1: Negative	Routine screening	~0%
2: Benign	Routine screening	~0%
3: Probably benign	Short-interval follow-up or continued surveillance	>0% but 2%
4: Suspicious	Biopsy	>2% but <95%
4A: Low suspicion	>2% but 10%
4B: Moderate suspicion	>10% but 50%
4C: High suspicion	>50% but <95%
5: Highly suggestive of malignancy

Next page

1234567...261

Light

Font size:

↓

↑

Georgia Tahoma Arial Verdana

Reset

Interval:

↓

↑

Bookmark:

Make

Similar books «A Comprehensive Guide to Core Needle Biopsies of the Breast»

Look at similar books to A Comprehensive Guide to Core Needle Biopsies of the Breast. We have selected literature similar in name and meaning in the hope of providing readers with more options to find new, interesting, not yet read works.

Juliette Michelet

Beginners Guide to Punch Needle Projects: 26 Accessories and Decorations to Embroider in Relief

Lucia Giuggio Carvalho

The Everything Health Guide to Living with Breast Cancer: An accessible and comprehensive resource for women

Kenneth D. Miller

The Breast Cancer Book: A Trusted Guide for You and Your Loved Ones

Ruth ORegan

Breast Cancer Journey: The Essential Guide to Treatment and Recovery

Dana Brantley-Sieders

Talking to My Tatas: All You Need to Know from a Breast Cancer Researcher and Survivor

Jennifer A. Shin

Living with Breast Cancer: The Step-by-Step Guide to Minimizing Side Effects and Maximizing Quality of Life

M.D. Shah

Breast Imaging: A Core Review

Biren A Shah MDFACR

Breast Imaging: A Core Review, 2e

Ashing Kimlin Tam

Detecting and Living with Breast Cancer For Dummies

Florence Schaffner

Tumor Liquid Biopsies

Takamaro Shigaraki

Heart of the Shin Buddhist Path: A Life of Awakening

Chris Flowers

Image Guided Core Biopsy of the Breast: A Practical Approach

Discussion, reviews of the book A Comprehensive Guide to Core Needle Biopsies of the Breast and just readers' own opinions. Leave your comments, write what you think about the work, its meaning or the main characters. Specify what exactly you liked and what you didn't like, and why you think so.