Imaging-guided core biopsies in the breast

Screening mammography programs have contributed to an overall decline in breast cancer mortality. The screening process, however, also results in detection and biopsy of many nonpalpable lesions that eventually prove to be benign, contributing to the burden of costs to our health care system. Percutaneous imaging-guided core biopsy has proven to be a safe and accurate technique for obtaining a histologic diagnosis in most patients who have screening-detected lesions; it is done at lower cost with lower resultant morbidity to the patient compared with traditional surgical excisional biopsy. I review the indications, techniques, method of correlating the histology with mammographic findings, and accreditation requirements for imaging guided core biopsies of the breast done under mammographic (ie, stereotactic) or sonographic guidance.