Systematic Review: Comparative Effectiveness of Core-Needle and Open Surgical Biopsy to Diagnose Breast Lesions
- 16 February 2010
- journal article
- review article
- Published by American College of Physicians in Annals of Internal Medicine
- Vol. 152 (4), 238-246
- https://doi.org/10.7326/0003-4819-152-1-201001050-00190
Abstract
Background: Most women undergoing breast biopsy are found not to have cancer. Purpose: To compare the accuracy and harms of different breast biopsy methods in average-risk women suspected of having breast cancer. Data Sources: Databases, including MEDLINE and EMBASE, searched from 1990 to September 2009. Study Selection: Studies that compared core-needle biopsy diagnoses with open surgical diagnoses or clinical follow-up. Data Extraction: Data were abstracted by 1 of 3 researchers and verified by the primary investigator. Data Synthesis: 33 studies of stereotactic automated gun biopsy; 22 studies of stereotactic-guided, vacuum-assisted biopsy; 16 studies of ultrasonography-guided, automated gun biopsy; 7 studies of ultrasonography-guided, vacuum-assisted biopsy; and 5 studies of freehand automated gun biopsy met the inclusion criteria. Low-strength evidence showed that core-needle biopsies conducted under stereotactic guidance with vacuum assistance distinguished between malignant and benign lesions with an accuracy similar to that of open surgical biopsy. Ultrasonography-guided biopsies were also very accurate. The risk for severe complications is lower with core-needle biopsy than with open surgical procedures (Limitation: The strength of evidence was rated low for accuracy outcomes because the studies did not report important details required to assess the risk for bias. Conclusion: Stereotactic- and ultrasonography-guided core-needle biopsy procedures seem to be almost as accurate as open surgical biopsy, with lower complication rates. Primary Funding Source: Agency for Healthcare Research and Quality.This publication has 30 references indexed in Scilit:
- Sonographically Guided 14-Gauge Core Needle Biopsy of Breast Masses: A Review of 2,420 Cases with Long-Term Follow-UpAmerican Journal of Roentgenology, 2008
- Diagnostic performance of stereotactic large core needle biopsy for nonpalpable breast lesions in routine clinical practiceInternational Journal of Cancer, 2007
- Ultrasound-guided core needle biopsy of breast masses: How many cores are necessary to diagnose cancer?Journal of Clinical Ultrasound, 2007
- Dynamic contrast-enhanced MR imaging in screening detected microcalcification lesions of the breast: is there any value?Breast Cancer Research and Treatment, 2006
- Accuracy and Underestimation of Malignancy of Breast Core Needle Biopsy: the Florence Experience of Over 4000 Consecutive BiopsiesBreast Cancer Research and Treatment, 2006
- Vacuum-assisted breast biopsies: Experience at the Antoine Lacassagne Cancer Center (Nice, France)Clinical Imaging, 2006
- The Accuracy of Ultrasound, Stereotactic, and Clinical Core Biopsies in the Diagnosis of Breast Cancer, With an Analysis of False-Negative CasesAnnals of Surgery, 2005
- Measuring inconsistency in meta-analysesBMJ, 2003
- Quantifying heterogeneity in a meta-analysisStatistics in Medicine, 2002
- Diagnostic accuracy of stereotactic large‐core needle biopsy for nonpalpable breast disease: Results of a multicenter prospective study with 95% surgical confirmationInternational Journal of Cancer, 2002