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| |  Large Core Needle Breast Biopsy Is Accurate Alternative To Surgical Excision WASHINGTON, DC -- May 4, 1999 -- For women who need a breast biopsy, an effective, less invasive procedure than surgical excision (cutting out tissue) is a large core needle biopsy (LCNB), according to an article in tomorrow’s issue of The Journal of the American Medical Association, a theme issue on cancer. Jack Meyer, M.D., and colleagues at Brigham and Women’s Hospital in Boston, investigated whether LCNB is a safe and accurate technique to evaluate abnormalities found on breast imaging studies. They examined the results of 1,836 LCNBs of suspicious breast lesions visible on mammography or ultrasound over a six-year period. A 14- or 11-gauge needle with stereotactic localisation or ultrasound imaging guidance was utilised. Dr. Meyer presented the findings of the study at an American Medical Association media briefing on cancer today. "In summary, we have found LCNB of suspicious breast abnormalities accurate, safe and well accepted by patients and referring physicians," the authors write. "Overutilisation is not apparent in our experience." In a separate interview, Dr. Meyer said women will prefer this procedure (LCNB) because it requires only local anesthesia, no stitches, can be scheduled quickly and performed in about an hour. "Most patients resume normal activities right after the biopsy," he said. The researchers add that another advantage of LCNB over surgical biopsy is reduced cost, by many estimates one-half to one-third. "In addition, when a carcinoma is initially diagnosed with LCNB, significantly fewer surgical procedures are required to achieve clear margins when breast conservation is the therapeutic goal," Dr. Meyer said. "In addition to cost saving, LCNB is more easily scheduled and takes less time to perform." According to Dr. Meyer, the widespread use of screening mammography has resulted in the identification of an increasing number of abnormalities requiring breast biopsy and LCNB has become an alternative to surgical excision. Since the majority of these abnormalities for which biopsy is recommended are benign (70 percent to 80 percent), a high percentage of women do not need a subsequent surgical excision after LCNB. The recent introduction of the directional, vacuum-assisted biopsy (DVA) instrument has allowed harvesting of larger quantities of tissue with a single needle insertion. For example, the average weight of a biopsy sample obtained with a traditional automated 14-gauge needle has been reported to be 17 mg, compared with 44 mg and 105 mg respectively, with 14-gauge and 11-gauge needles using the DVA device. This instrument has a high-speed rotating cutter which can be positioned to sample the tissue adjacent to the needle over 360 degrees. Related Link: The Journal of the American Medical Association
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