• Aqeel Alameer, Matthew Common, ElwahabSami AbdSADepartment of Surgery, Beaumont Hospital, Dublin, Ireland., Michael Boland, Michael Allen, Colm Power, Niamh Hambly, Jennifer Kerr, Neasa Ni Mhuircheartaigh, Marie Staunton, HillArnold D KADKDepartment of Surgery, Beaumont Hospital, Dublin, Ireland., and Deirdre Duke.
• Department of Surgery, Beaumont Hospital, Dublin, Ireland. aqeel.alameer@nhs.scot.
• Ir J Med Sci. 2023 Feb 1; 192 (1): 317319317-319.

ObjectiveThe vast majority of breast cancers are diagnosed via image-guided procedures yet despite significant advances, imaging does not identify all breast malignancies. Clinically suspicious breast lesions with normal breast imaging remain a cause for concern. The aim of this study is to determine the diagnostic value of clinical core and cutaneous punch biopsies in the diagnosis of breast malignancy in clinically suspicious lesions with normal breast imaging.MethodsAll patients with suspicious clinical breast findings and normal imaging who underwent a clinical core and/or cutaneous punch biopsy from 2012 to 2019 were reviewed retrospectively. Patients with subsequent breast malignant diagnosis were analysed.ResultsA total of 283 biopsies (166 clinical core, 117 cutaneous punch) performed over the 7-year period were included in the analysis. A total of 263/283 (93%) yielded a benign outcome. A total of 2/283 (0.7%) yielded B3 lesions (probably benign). These lesions were benign on final surgical excision. A total of 18/283 (6.3%) yielded a malignant histopathology. Sixteen out of 18 were cutaneous punch biopsies, and 2/18 were clinical core biopsies. A total of 14/18 patients presented with nipple changes, while 4/18 had a palpable area of concern. Histopathological analysis demonstrated Paget's disease of the nipple in 8/18, invasive carcinoma in 9/18 out of which two represented a recurrence of breast malignancy. Cutaneous squamous cell carcinoma was diagnosed in 1/18.ConclusionClinical core and cutaneous punch biopsies remain a valuable tool in the diagnosis of breast cancer particularly in the management of clinically suspicious radiographically occult malignancies.© 2022. Crown.

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