Core Needle Biopsy: Accurate with Fewer Complications

Several types of biopsies can be performed when breast cancer is suspected -- each with unique pros and cons. Core needle biopsy is known to have fewer complications and a shorter recovery time than surgical biopsy. But is it as accurate? A new study published in Annals of Internal Medicine suggests it comes close.

Biopsy Basics

When you have a biopsy, a doctor takes a sample of the suspicious area that might be cancer and looks at it under a microscope.

During a surgical biopsy (also called open biopsy), all or part of the problem area, as well as some of the surrounding tissue, is removed. The procedure can be done using local pain reliever or under general anesthesia. Because surgical biopsy uses a scalpel to make an incision in the skin, it often requires stitches and may leave a scar.

A core needle biopsy is a simpler, less invasive procedure. It uses a large, hollow needle that removes a core of tissue. The procedure is done using local pain reliever. The recovery time is shorter than with surgical biopsy. In most cases no scarring occurs.

Other types of biopsy include fine needle aspiration biopsy and vacuum-assisted biopsy.

Comparing Biopsy Methods

Researchers analyzed data from 107 studies that compared different biopsy methods. Women enrolled in these studies had been found to have suspicious breast abnormalities during routine screening. Accuracy of their biopsies was then determined by comparing their biopsy results with findings from patient follow-up or surgery.

All tolled, the researchers found that core needle biopsy and surgical biopsy were similar in accuracy. Core needle biopsy was 86 to 99 percent accurate. Surgical biopsy was 98 to 99 percent accurate.

However, severe complications from core needle biopsy occurred in less than 1 percent of cases, compared with 2 to 10 percent for surgical biopsy. Examples of severe complications included bleeding, infection, and pain.

In addition, women diagnosed with cancer by core needle biopsy were more likely to be treated with only one surgical procedure than women diagnosed by surgical biopsy.

The researchers caution that many of the individual studies had design flaws. However, the studies were large and consistent enough to suggest that core needle biopsy is nearly as accurate as surgical biopsy.

Choosing Which Biopsy to Have

Not every woman may be eligible for core needle biopsy. Which type of biopsy you should have depends on several factors, including:

• How suspicious the lesion appears
• Size and location of the lesion
• Number of lesions found
• Other health problems you might have
• Personal preference

Before you make a decision about breast biopsy, talk with your doctor to find out which option is best for you.