Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging: Insights into Imaging

U. Bick, R.M. Trimboli, A. Athanasiou, C. Balleyguier, P.A.T. Baltzer, M. Bernathova, K. Borbély, B. Brkljacic, L.A. Carbonaro, P. Clauser, E. Cassano, C. Colin, G. Esen, A. Evans, E.M. Fallenberg, M.H. Fuchsjaeger, F.J. Gilbert, T.H. Helbich, S.H. Heywang-Köbrunner, M. HerranzK. Kinkel, F. Kilburn-Toppin, C.K. Kuhl, M. Lesaru, M.B.I. Lobbes, R.M. Mann, L. Martincich, P. Panizza, F. Pediconi, R.M. Pijnappel, K. Pinker, S. Schiaffino, T. Sella, I. Thomassin-Naggara, A. Tardivon, C.V. Ongeval, M.G. Wallis, S. Zackrisson, G. Forrai, J.C. Herrero, F. Sardanelli, with language review by Europa Donna-The European Breast Cancer Coalition for the European Society of Breast Imaging (EUSOBI)

Research output: Contribution to journalArticlepeer-review


We summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriate combination of device type for sampling and imaging technique for guidance. Then, we describe the commonly used devices, from fine-needle sampling to tissue biopsy with larger needles, namely core needle biopsy and vacuum-assisted biopsy, and how mammography, digital breast tomosynthesis, ultrasound, or magnetic resonance imaging work for targeting the lesion for sampling or localisation. The differences among the techniques available for localisation (carbon marking, metallic wire, radiotracer injection, radioactive seed, and magnetic seed localisation) are illustrated. Type and rate of possible complications are described and the issue of concomitant antiplatelet or anticoagulant therapy is also addressed. The importance of pathological-radiological correlation is highlighted: when evaluating the results of any needle sampling, the radiologist must check the concordance between the cytology/pathology report of the sample and the radiological appearance of the biopsied lesion. We recommend that special attention is paid to a proper and tactful approach when communicating to the woman the need for tissue sampling as well as the possibility of cancer diagnosis, repeat tissue sampling, and or even surgery when tissue sampling shows a lesion with uncertain malignant potential (also referred to as “high-risk” or B3 lesions). Finally, seven frequently asked questions are answered. © 2020, The Author(s).
Original languageEnglish
Article number12
JournalInsights Imaging
Issue number1
Publication statusPublished - 2020


  • Breast
  • Breast lesion localisation
  • Core needle biopsy
  • Fine-needle sampling
  • Vacuum-assisted biopsy
  • anticoagulant agent
  • Article
  • axillary lymph node
  • bone scintiscanning
  • brachytherapy
  • breast biopsy
  • breast cancer
  • cancer diagnosis
  • cancer surgery
  • computer assisted tomography
  • digital breast tomosynthesis
  • echography
  • female
  • fine needle aspiration biopsy
  • follow up
  • histology
  • histopathology
  • human
  • image guided biopsy
  • imaging
  • lumpectomy
  • lymph node dissection
  • lymphoscintigraphy
  • mammography
  • mastectomy
  • medical society
  • needle biopsy
  • nuclear magnetic resonance imaging
  • percutaneous biopsy
  • percutaneous drainage
  • radiation dose
  • radiation exposure
  • sampling
  • sensitivity and specificity
  • sentinel lymph node biopsy
  • stereotactic biopsy
  • tumor invasion
  • tumor regression
  • vacuum assisted biopsy
  • water immersion


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