Avoidable and Unavoidable Repeat Breast Core Needle Biopsies

Background: Breast core needle biopsies are not perfect and could miss cancer. The need for a repeat breast core biopsy is not uncommon and can occur for a multitude of reasons. Radiologists should carefully correlate the pathology results with imaging features after each breast biopsy and must recognize why certain core biopsies must be repeated to avoid missed or delayed cancer diagnosis. In this review, we discuss the main reasons for repeat core biopsies via case presentation with radiological images and pathological correlation. This review will help multidisciplinary breast care team recognize when to repeat a biopsy to reduce false negatives and will also familiarize radiologists with techniques for improving initial biopsy success. Methods: We performed literature and chart reviews of cases at our institution between January 2015 and December 2019. Results: While some repeat biopsies are inevitable, most can be avoided with careful pre-biopsy planning, adequate sampling techniques, and proper radiological-pathological correlation. Conclusion: Repeat breast core needle biopsies occur due to multiple avoidable and unavoidable radiological or pathological issues. It is imperative for both multidisciplinary breast care team and radiologists to recognize when to repeat a biopsy to reduce false negative or delayed cancer diagnosis via careful reviews before and after the procedure and adequate radiological and pathological correlation.