Authors' objectives: Core needle biopsy and open surgical biopsy are the most frequently used procedures for diagnosis of suspicious breast lesions. An AHRQ evidence report on the comparative effectiveness and adverse events of breast biopsy methods was completed in 2009. The availability of additional studies and the uncertainties surrounding newer biopsy techniques prompted an update of that report.

Authors' recommendations: A large body of evidence suggests that ultrasound and stereotactically guided core needle biopsy procedures have sensitivity and specificity close to that of open biopsy procedures, and are associated with fewer adverse events. The strength of the evidence on the test performance of these methods is deemed moderate because studies are at medium to high risk of bias, but provide precise and fairly consistent results. Freehand procedures have lower sensitivity than imaging-guided methods. The strength of evidence on the comparative test performance of automated and vacuum-assisted devices (when using the same imaging guidance) is deemed low, because of concerns about the risk of bias of included studies and the reliance on indirect comparisons. There were insufficient data to draw conclusions for MRI-guided biopsy or women at high baseline risk of cancer. There is low strength of evidence that vacuum-assisted procedures have a higher risk of bleeding than automated methods. There is moderate strength of evidence that women diagnosed with breast cancer by core needle biopsy are more likely to have their cancer treated with a single surgical procedure, compared with women diagnosed by open surgical biopsy.

Project Status: Completed

Year Published: 2014

URL for published report: http://www.effectivehealthcare.ahrq.gov/ehc/products/543/1960/breast-biopsy-update-report-140910.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)