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Introduction
Preoperative verification of focal lesions in the breasts is crucial for further therapeutic decisions. Three most common techniques include: fine-needle aspiration biopsy (FNAB), core-needle biopsy (CNB) and vacuum-assisted biopsy (VAB).
Fine-needle aspiration biopsy was first used in 1930 in New York by Hayes Martin and Edward Ellis. Unfortunately, this method was not popular for the next 25 years. It started to be commonly used in the diagnostic process of palpable breast masses in the 1950s in the Scandinavian Karolinska Institute. FNAB was first used in Poland in the mid-1970s in Szczecin on the initiative of Professor Stanisław Woyke.
Core-needle biopsy was introduced in the 1990s, initially only for clinically silent lesions. However, it rapidly began replacing fine-needle biopsy(1,2). This method owes its growing popularity not only to its accuracy in the diagnosis of benign lesions, but mostly to its capability of distinguishing between in situ lesions and invasive carcinoma(3).
Unquestionable advantages of FNAB include: ready availability, simplicity of the technique, low cost and, most of all, low risk of complications. It requires no anesthesia, is minimally-invasive and relatively patient-friendly (associated with little discomfort). Also, it is the most suitable for patients receiving anticoagulant therapy since it does not require its discontinuation. Moreover, the biopsy result is available several days after specimen collection.
Core-needle biopsy is an invasive procedure conducted under local anesthesia and with image guidance (US, MMG, MRI). The equipment needed includes a biopsy instrument and a needle with a large diameter(4). Complications after the procedure include a hematoma (<2%), pain and discomfort(5). Although these complications are more common than after fine-needle biopsy, the percentage is only slightly higher. In the case of a biopsy of a relatively small lesion, it is possible to remove it completely or break it into pieces, which might make surgical excision and histopathological analysis more difficult. In such cases, it is recommended that a tracer should be administered in the region of the lesion to be biopsied.
A lot of authors have compared the sensitivity, specificity and other aspects of FNAB and CNB. Such an assessment is frequently problematic due to differences regarding employed methods, experience in performing biopsy and cytological interpretation.
In a meta-analysis based on over 20...