I wrote an article a while back called “What Your Core Needle Biopsy Diagnosis Means” to help patients understand why sometimes even a “benign” diagnosis may require a surgical excision.  While writing that article, I spoke to many of my colleagues in breast pathology and breast imaging and found out that there is a marked [...]

Question: Hello, I just received the results of my core biopsy, I would like you opinion on it. Proliferated fibrocystic changes comprised of ductal epithelial hyerlasia with focal atypia, duct single minute microcalcification seen in benign fibrotic tissue. Patient needs surgery consult for breast biopsy. At this point, what do you think my risk is for cancer? I [...]

Question: After several years of mammograms showing mild calcifications, this year I was informed that the radiologist saw some mild changes in the calcifications. I did another mammogram, followed by a core biopsy. The initial report came back benign, but the final came back as atypical ductal hyperplasia. I am now scheduled [...]

In the current issue of Cancer (April 1), there is a an interesting news article summarizing the findings of the 3rd International Consensus Conference on Image-Detected Breast Cancer. The expert panel suggests that in up to 35% of cases, patients are undergoing unnecessary open surgical biopsies as a first diagnostic procedure when core needle biopsy [...]

Our poster “High Risks Breast Lesions: Still No Standard of Core”, which we co-authored with Dr. Dianne Georgian-Smith of Harvard Medical School, will be presented at the 20th annual meeting of the National Consortium of Breast Centers this March 20th-24th in Las Vegas.  This is an interdisciplinary meeting of breast healthcare professionals from around the [...]

Question: I had a stereotactic core biopsy of cluster of calcifications in the upper inner left breast. Path diagnosis columnar cell change and hyperplasia with focal atypical micropapillary hyperplasia with microcalcifications. surgicial excision is recommended. From my understanding this is not cancer but has the potential to be cancer down the road. I [...]

My colleague, Dr. Dianne Georgian-Smith of Harvard Medical School, and I recently wrote a Letter to the Editor to the American Journal of Roentgenology discussing our views on treatment of “high risk” breast lesions diagnosed on core needle biopsy.

Question: I had a core biopsy for calcium in my right breast that showed “focal atypical lobular hyperplasia” – my doctor recommended surgery but I chose to get a second opinion and that said my biopsy was benign and said there was no atypical lobular hyperplasia. I would prefer not to have surgery but [...]

Question: My mammogram had some new calcifications and I underwent needle biopsy. My doctor said there was no cancer but that the calcifications weren’t in my biopsy. They say I need to have surgery but if everything is benign I don’t understand why? Can calcifications disappear?

In the past decade, core needle biopsy has taken over fine needle aspiration (FNA) as the main tool for diagnosing image-detected or palpable breast lesions. While this biopsy technique is just a sample, cores of breast tissue are removed vs. individual cells as in FNA and thus the pathologist has more information to make an [...]