A woman who has a an abnormal mammogram or other screening test, and is told that she has calcium deposits in her breast, called calcifications or microcalcifications, that may or may not be a sign of cancer, may wish to have the lesion tested. For this, a sample of tissue (biopsy) needs to be taken from her breast to test for cancer.

This recommendation evaluates the type of guidance used to obtain a sample using needle core biopsy.

Healthcare question

Should stereotactic-guided needle core biopsy or stereotactic-guided vacuum assisted needle core biopsy vs. ultrasound-guided needle core biopsy or ultrasound-guided vacuum assisted needle core biopsy be used to diagnose breast cancer in individuals with breast calcifications?

Recommendation

In individuals presenting with breast calcifications, the ECIBC's Guidelines Development Group (GDG) recommends the use of stereotactic-guided needle core biopsy over ultrasound-guided needle core biopsy to diagnose the presence of breast cancer.

Recommendation strength ­

  Strong recommendation for the intervention

  Low certainty of the evidence

Considerations for implementation and policy making

  1. Training for radiologists who currently biopsy for calcifications using ultrasound-guided NCB.
  2. The GDG noted that effective communication strategies are critical so that women can make informed decisions throughout all phases of the screening process.
  3. In settings where stereotactic equipment is not widely available there may be a need to consider how to refer patients to a reference setting where they can have access to stereotactic-guided biopsy.

Research priorities

Research was suggested on communication strategies for diagnostic tests that are used in different settings, in order to promote informed decision-making by women.

Supporting documents