Breast Interventions: Biopsy and Localization Techniques

Image guided breast interventions have become integral component of management protocol in patients with breast diseases. It mainly includes breast biopsy and preoperative lesion localization in order to establish the pathological diagnosis. Patients with suspicious findings on imaging undergo core needle biopsy using 14 G biopsy needle and rad-path correlation. Any discordance should be addressed with review of images and consideration for repeat biopsy. Repeat biopsy may be vacuum assisted which yields better tissue cores for pathological evaluation and is considered as equivalent to surgical biopsy. On the other hand of spectrum is localization of non-palpable lesions either detected during screening test or resolution post neo-adjuvant chemotheraphy for breast cancer. In our country, hookwire placement is done for these patients on the day of surgery which needs close communication between the radiologist and surgeons. This chapter aims to discuss these minimally invasive techniques of breast interventions falling under the purview of radiology.