Accuracy and outcomes of stereotactic vacuum‐assisted breast biopsy for diagnosis and management of nonpalpable breast lesions

Abstract

Stereotactic vacuum‐assisted biopsy (SVAB) is an alternative method of breast biopsy for nonpalpable lesions detected by mammography. Considering the diagnostic effectiveness, a direct comparison of SVAB and open surgical biopsy (OSB) is lacking. We performed a retrospective review of 276 (33.8%) SVAB and 541 (66.2%) OSB to compare the diagnostic accuracy and the total number of procedures the patients underwent. The negative predictive values of OSB and SVAB were 99.77% and 99.61%, and their false‐negative rates were 0.96% and 4.76%, respectively. SVAB, as the first‐line biopsy method, obviated 92.3% of operations. All malignancies diagnosed using SVAB could be treated with single therapeutic surgery. By contrast, 48% of malignancies of OSB group received two operations. Breast Imaging Reporting and Data System (BI‐RADS) category used at the study correlated well with the percentage of malignancy and can thus be used to predict biopsy results. Our study concluded that SVAB is reliable for diagnosing nonpalpable breast lesions and is the better biopsy method for categories 3 and 4A lesions, which reduces the benign surgery rate. For lesions with a higher likelihood of malignancy, BI‐RADS 4B, 4C and 5, SVAB has an advantage over OSB, which lowers the total number of operations for malignancy treatment.

Diagnostic accuracy of tomosynthesis-guided vacuum assisted breast biopsy of ultrasound occult lesions

“…In our study, we found that the distribution of malignancies in BI-RADS category is similar with the standard guideline by American College of Radiology 16 . Our results corroborate with the findings of other studies which showed that the likelihood of malignancy increases with BI-RADS category 7,11,12,17,18 . Although calcifications play a crucial role in early breast cancer diagnosis, they are also associated with 63.2% of benign pathology 7 .…”

“…We found that the DCIS and ADH underestimation rate of our VABB were in line with previous studies. In a previous study by Tsai et al 11 , the DCIS underestimation rate was 16.7% while another study by Kettritz et al 17 revealed that underestimation of ADH and DCIS were 24% and 12%, respectively. Another recent study by Badan et al reported the underestimation rate of ADH was 25% and DCIS was 14.28% 13 .…”

“…Non-palpable mammographic lesions are one of the major challenges in diagnosis of breast cancer. Calcifications are the most frequent mammographic finding for early diagnosis of breast cancer 7,[10][11][12] . In our study, we found that the distribution of malignancies in BI-RADS category is similar with the standard guideline by American College of Radiology 16 .…”

“…A study performed by Penco et al reported that the sensitivity of VABB ranged from 99.7% to 100% and false negative rate of 1.7% to 7.1% in 4086 patients within 10 years duration 19 . Tsai et al reported that stereotactic VABB has a sensitivity of 95.24%, false-negative rate of 4.76% and NPV of 99.61% in 817 patients within 5 years duration 11 . Similarly, Kettritz et alachieved sensitivity and NPV of more than 99% 17 .…”

The influence of preoperative biopsy on the surgical method in breast cancer patients: a single-center experience of 3,966 cases in China

“…Also, US-guided localization surgery is more suitable for in situ cancers, invasive cancers which need neoadjuvant therapy and more accurate evaluation of neoadjuvant therapy response (17)(18)(19)(20)(21). Compared to the negative predictive value and false negative rate of open surgical biopsy (99.61% and 4.76%), the negative predictive value of VABB was 99.77% and the false negative rate was 0.96% (22). These results demonstrated that VABB under the guidance of US exhibited the same diagnostic coincidence rate as that of segmental resection.…”