Surgeon-controlled ultrasound-guided core biopsies in the breast – a prospective study and a new use for surgeons in the clinic

Aims: This study was to assess the accuracy of a surgeon performing ultrasound-guided core biopsies of the breast. Methods: A prospective audit was carried out of 555 patients who underwent an ultrasound-guided core biopsy for a discrete solid mass [under 30 mm maximum diameter] by a single surgeon. The surgeon controlled the core biopsy needle and an ultrasonographer or radiologist provided the imaging with ultrasound. Results: The accuracy of the surgeon in sampling the lesions [ n=555 core biopsies] was independent of the size of the lesion. This saved 272 patients having unnecessary surgery for a benign lesion. Conclusion: The practical involvement by the surgeon in breast ultrasound and performing core biopsies has reduced pressure on the breast radiologists, reduced the number of diagnostic surgical open biopsies and made the clinic more interesting for the surgeon. With increased surgical confidence in breast ultrasound, most small and impalpable cancers have pre-operative skin marking rather than X-ray wire localization prior to undergoing wide local excision. Trainee breast surgeons should be encouraged to learn breast ultrasound and core biopsies.