Image-guided breast biopsy programme quality evaluation
- F Burbank1
© BioMed Central 2006
Published: 10 July 2006
Image-guided breast biopsy programs are a clinical reality at breast care centers throughout the world. Because image-guided biopsy is a departure from traditional surgical breast biopsy, the quality of each new image-guided breast biopsy program should be measured. A generalized scheme for quality evaluation will be presented.
The most complex part of this scheme is the comparison of tissue samples obtained by image-guided biopsy with tissue samples subsequently obtained during surgery. Because image-guided biopsy programs retrieve histology specimens that are microscopically as valid as histology obtained from open surgery, comparing the histology from an image-guided breast biopsy with the histology from an open surgical biopsy is complex. One cannot use the well-known method of determining false-negative and false-positive rates. In addition, breast histology, itself, is quite complex. Some benign breast disease is quite focal and specific, such as fibroadenomas. Other benign breast disease is diffuse and not very specific, such as fibrocystic abnormalities. Furthermore, malignant breast disease is part of a histology spectrum starting with normal-looking breast tissue with atypical features, progressing to carcinoma in situ, and ending, finally, with infiltrating breast cancer. To illustrate how histological comparisons should be made for breast tissue, published results from a large, nationally funded study will be re-examined using the proposed scheme.
Although the breast biopsy, itself, may seem like the hard work of a new breast biopsy program, it is not. After the first year of the program, follow-up of women who have been biopsied is the true, back-breaking, hard work. How a breast center should perform air-tight follow-up will be described.