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Beyond the technical aspects, success and long-term patient outcomes of image-guided breast biopsies depend on the overall patient experience. Patient experience in turn is influenced by intangible factors, such as environmental features during the procedure; patient-centered communication prior to, during, and subsequent to the procedure; and management of expectations and biopsy complications. Here, we review evidence-based literature and results of a national Society of Breast Imaging survey on approaches to both mitigate and manage common image-guided core biopsy complications as well as nontechnical strategies to improve the patient biopsy experience., (© Society of Breast Imaging 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Invasive lobular carcinoma (ILC) is the second-most common histologic subtype of breast cancer, constituting 5% to 15% of all breast cancers. It is characterized by an infiltrating growth pattern that may decrease detectability on mammography and US. The use of digital breast tomosynthesis (DBT) improves conspicuity of ILC, and sensitivity is 80% to 88% for ILC. Sensitivity of mammography is lower in dense breasts, and breast tomosynthesis has better sensitivity for ILC in dense breasts compared with digital mammography (DM). Screening US identifies additional ILCs even after DBT, with a supplemental cancer detection rate of 0 to 1.2 ILC per 1000 examinations. Thirteen percent of incremental cancers found by screening US are ILCs. Breast MRI has a sensitivity of 93% for ILC. Abbreviated breast MRI also has high sensitivity but may be limited due to delayed enhancement in ILC. Contrast-enhanced mammography has improved sensitivity for ILC compared with DM, with higher specificity than breast MRI. In summary, supplemental screening modalities increase detection of ILC, with MRI demonstrating the highest sensitivity., (© Society of Breast Imaging 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)