Utilizing digital breast tomosynthesis to improve accuracy of preoperative needle localization for surgical excisional biopsy

• Published in: Delaware medical journal Vol. 87; no. 4; p. 117
• Main Authors: Hasan, Rabia, Gavenonis, Sara C, Shin, Min-Chul F
• Format: Journal Article
• Language: English
• Published: United States 01.04.2015
• Subjects: Aged, 80 and over; Biopsy, Needle - methods; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Carcinoma, Intraductal, Noninfiltrating - diagnostic imaging; Carcinoma, Intraductal, Noninfiltrating - pathology; Carcinoma, Intraductal, Noninfiltrating - surgery; Female; Humans; Mammography - methods; Predictive Value of Tests; Preoperative Care; Radiographic Image Enhancement - methods; Radiographic Image Interpretation, Computer-Assisted - methods; Radiography, Interventional; Reproducibility of Results; Sensitivity and Specificity
• ISSN: 0011-7781

We describe a case of an 88-year-old female who presented for needle localization to undergo excisional biopsy of a subtle asymmetry in the left breast, with successful localization achieved using digital breast tomosynthesis. Initial attempts at localization under 2D mammography were inaccurate. Subsequent digital breast tomosynthesis application for triangulation resulted in better visualization of the target, and successful localization. Specimen radiography confirmed the lesion was accurately targeted and pathology revealed ductal carcinoma in situ. Needle localization guided by mammography and inherent limitations of 2D mammography are discussed, along with a literature review of tomosynthesis guided needle localization.