The purpose of our educational exhibit is to review the different indications for surgical excisional breast biopsy. After reviewing this exhibit, the reader will be able to recognize the clinical situations and the breast pathologies for which excisional breast biopsy should be recommended.

While historically excisional breast biopsy was the gold standard, nowadays a imaging-guided core percutaneous biopsy is usually sufficient for diagnosis of most breast lesions. However, there are times when an excisional biopsy should be recommended. Familiarity with these indications is important for patients' management.

Clinical situations where excisional breast biopsy should be recommended include: 1) Discordance between imaging findings and core biopsy pathology: Despite being reliable and accurate for the diagnosis of both benign and malignant diseases of the breast, core needle biopsy still carries the possibility of a false-negative biopsy pathologic diagnosis even with optimized technique. Hence imaging-pathology correlation is of critical importance in imaging-guided breast biopsies to detect the possibility of sampling error and to avoid a delay in diagnosis. Up to 64% of discordant lesions after...

While image guided percutaneous core needle biopsy is usually sufficient for diagnosis of most breast lesions, a diagnostic surgical excisional biopsy should be considered in certain situations. It is important to recognize these indications and discuss them with the patients and breast surgeons for best management. Careful imaging-pathology correlation and appropriated post-biopsy management should be the cornerstone of a successful core biopsy program. It identifies discordant lesions prospectively and allow the detection of false-negative results immediately after biopsy, thereby avoiding delays in cancer diagnosis. With...

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