Issued on: February 2017
Should stereotactic-guided needle core biopsy or stereotactic-guided vacuum assisted needle core biopsy vs. ultrasound-guided needle core biopsy or ultrasound-guided vacuum assisted needle core biopsy be used to diagnose the presence of breast cancer in individuals presenting with breast calcifications?
In individuals presenting with breast calcifications, the ECIBC's Guidelines Development Group (GDG) recommends the use of stereotactic-guided needle core biopsy over ultrasound-guided needle core biopsy to diagnose the presence of breast cancer.
The GDG noted that while stereotactic guidance is favourable, in practice there was low certainty in the evidence reviewed that compared stereotactic to ultrasound guidance. Despite this, the GDG agreed that, when comparing stereotactic-guided NCB with open biopsy, the recommendation was strong and the certainty of this evidence was high. However, when comparing stereotactic guidance to ultrasound guidance, as there were no studies directly comparing both interventions, the overall certainty of the evidence was low, due to the low quality of the evidence for ultrasound guidance compared to open biopsy, as well as the fact that only two studies were found on ultrasound guidance. The GDG agreed to issue a strong recommendation in favour of the use of stereotactic guidance for biopsy evaluation of breast calcification despite the low certainty of the evidence.
The radiologist GDG members advised the group that this technique poses less risk for the individual and permits accurate visualisation and targeted biopsy of the calcification. The GDG histopathologists confirmed that their experience indicates that stereotactic-guided biopsy is far superior to ultrasound-guided biopsy in obtaining representative tissue samples of calcification for microscopic evaluation.
Research was suggested on communication strategies for diagnostic tests that are used in different settings, in order to promote informed decision-making by women.
