Core needle biopsy is typically performed under guidance with which imaging modalities?

Core needle biopsy is typically performed under guidance with which imaging modalities?

• A. Ultrasound or mammography guidance (stereotactic biopsy)
• B. CT guidance
• C. MRI guidance
• D. Fluoroscopy guidance

Answer: (A)

Guiding a breast core needle biopsy relies on imaging that can precisely localize the target and allow safe needle placement. Ultrasound guidance is common because it provides real-time visualization of the needle and target, is radiation-free, quick, and effective for lesions visible on ultrasound. When a lesion is only seen on mammography (often nonpalpable calcifications) or is best localized in three dimensions, stereotactic biopsy under mammographic guidance uses X-ray triangulation to accurately target the area. Other modalities—CT, MRI, or fluoroscopy—are less typical for routine diagnostic core needle biopsies: CT and fluoroscopy are not standard due to radiation and limited real-time localization; MRI guidance is used for lesions seen only on MRI or in special situations and is more resource-intensive. Therefore, the typical guidance options are ultrasound or mammography guidance (stereotactic biopsy).

Guiding a breast core needle biopsy relies on imaging that can precisely localize the target and allow safe needle placement. Ultrasound guidance is common because it provides real-time visualization of the needle and target, is radiation-free, quick, and effective for lesions visible on ultrasound. When a lesion is only seen on mammography (often nonpalpable calcifications) or is best localized in three dimensions, stereotactic biopsy under mammographic guidance uses X-ray triangulation to accurately target the area. Other modalities—CT, MRI, or fluoroscopy—are less typical for routine diagnostic core needle biopsies: CT and fluoroscopy are not standard due to radiation and limited real-time localization; MRI guidance is used for lesions seen only on MRI or in special situations and is more resource-intensive. Therefore, the typical guidance options are ultrasound or mammography guidance (stereotactic biopsy).