Nonpalpable breast lesion. Stereotaxic core needle aspiration biopsy with a single pass.

One hundred and fifty-six patients with suspect nonpalpable breast lesion underwent stereotaxic core needle aspiration biopsy (SCNAB) with a single pass in an upright "add-on" stereotaxic device using a manual 1.6-mm needle (16 G), to determine whether the results were comparable to results of SCNAB with a multiple-pass technique. Of the 69 carcinomas, 51 (74%) were correctly diagnosed and definitive surgical therapy, without surgical biopsy, was performed in 42 of the 50 invasive carcinomas (84%) and in 9 of the 19 noninvasive carcinomas (47%). Ten noninvasive carcinomas and 4 invasive carcinomas, discovered by microcalcifications or distortion on the mammograms, form 78% of the false-negative results. There were no false-positive results. Vasovagal reactions occurred in 11% of the procedures. Although the results were acceptable in patients with invasive carcinoma, more than one needle pass is necessary for greater diagnostic accuracy of SCNAB, especially in patients with only microcalcifications or distortion on the mammogram.