Principles of US-Guided Biopsies
Principles of US-Guided Biopsies
Search Pattern Assist ?Findings
What can we biopsy?
Masses visible on US [Yes/No]
Calcifications when clearly visible on US and an US guided biopsy is preferred to stereotactic biopsy [Yes/No]
Masses and nonmasses identified as US correlates for MRI findings that are suspicious [Yes/No]
Impression
What BIRADS should we proceed to biopsy?
-
BIRADS 3
When biopsy is preferable to short term follow up based on shared decision making with patient.
-
BIRADS 4
All lesions that are amenable to US biopsy. -
BIRADS 5
All lesions that are amenable to US biopsy. -
BIRADS 6
When there are additional lesions and knowledge of pathology will affect treatment.
What are the absolute contraindications for US-Guided Breast Biopsy?
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Inability to confidently identify target
-
Unable to safely biopsy due to proximity to chest wall
Recommendations
Compared to MRI:
Patient is more comfortable
No radiation
No IV contrast
Faster
Less expensive
Compared to stereotactic:
Patient is more comfortable
No radiation
Faster
Less expensive
Compared to surgical excision:
Patient is more comfortable
No general anesthesia
Less cosmetic scarring
Lower complication rate
Minimally invasive
Faster
Less expensive
