Image-Guided Breast Biopsies

The American Society of General Surgeons strongly supports the role of the qualified General Surgeon Specialist in image guided breast biopsies. Fractionated care is rarely comfortable or optimal for the patient. Breast surgeons are clinicians, highly skilled in the physical examination of the breast, the preoperative evaluation, and postoperative counseling of women with breast lesions. Technological evolution has brought ultrasound and mammograptically guided stereo core biopsy to the forefront of breast lesion diagnosis. These procedures allow excellent diagnostic accuracy with minimal scarring and breast deformity. To those who have continued the practice almost exclusively of excisional biopsy, the development of sentinel node technology will mitigate further for core biopsies to allow injection of tracer substance immediately adjacent to the tumor for accurate sentinel node identification. The judgment required to best guide the patient and choose appropriate procedures is within the training of the General Surgeon. The joint ACS/ACR statement on qualifications for stereotactic breast biopsy has published criteria which will allow individuals to qualify within their institution to perform these procedures. We must develop appropriate courses and CME activities to help our membership qualifying and keep qualified to perform these procedures.

The patient with breast lesions should have the right to a single well-trained individual who is concerned with their welfare and knowledgeable in all aspects of breast disease to take them through the arduous process of diagnosis and treatment. We must stand strongly together to support the role of the surgeon in the use of stereo core technology and other emergent technologies in the treatment of breast disease. There has been a revolution in technology, and qualified individuals should be supported so overall patient care can be achieved.