Stereotactic 9-gauge vacuum-assisted breast biopsy, how many specimens are needed?

Dekker, Bianca M. den; Diest, Paul J. van; Waard, Stephanie N. de; Verkooijen, Helena M.; Pijnappel, Ruud M.

doi:10.1016/j.ejrad.2019.108665

Cited by 11 publications

(5 citation statements)

References 30 publications

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“…Herein, we reported a higher number of specimens with nearly 15 per lesion in comparison to the literature (13). This result might be accredited to the fact that domestic patients are more inclined to have more tissue removed.…”

Section: Discussionmentioning

confidence: 52%

Value of stereotactic 11-gauge vacuum-assisted breast biopsy in non-palpable suspicious calcifications: an eight-year single institution experience with 587 patients

Yang

et al. 2020

Gland Surg

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Background: Vacuum-assisted breast biopsy (VABB) has been routinely recommended for stereotactic intervention in cases of isolate mammographically-detected calcifications. Herein we aimed to evaluate and compare the diagnostic consistency and accuracy of calcified and noncalcified specimens obtained from same sites of sampling on mammography-visible calcifications. In addition, we presented the biopsy procedure and retrospectively evaluated the usefulness of VABB as well as the complications of this technique over an eightyear experience in our centre.Methods: This single-institution observational cohort study included 587 patients referred for stereotactic 11-gauge VABB of 594 mammographically-detected calcifications between January 2010 and December 2018. The rate of histopathological underestimation, the false negative, the diagnostic consistency and accuracy between calcified and noncalcified specimens of VABB were comprehensively evaluated based on the surveillance data and final histopathological result of the surgical specimens.Results: In total, 594 biopsy procedures were performed in 587 patients (mean age 46 years, range, 21-80 years). The average number of biopsy specimens was 14.7 (range, 9-21) per lesion. VABB pathological results revealed 471 (79.3%) benign, 39 (6.6%) high-risk, and 84 (14.1%) malignant cases. The diagnostic inconsistency between calcified and noncalcified specimens was 14.6% (105/123) for high-risk and malignant lesions. Furthermore, calcified specimens exhibited higher diagnostic accuracy of malignant lesion as compared with the noncalcified specimens (97.7 % versus 82.6%, respectively). Underestimation rate for high-risk lesions and in situ carcinoma was 5.1% and 54.1%, respectively, along with a false negative rate of 6.25%. In addition, mild complications were reported with high patient tolerance.Conclusions: Stereotactic 11G-VABB might be preferred for the investigation of non-palpable mammographically-detected calcifications in terms of accuracy and safety profile. The high prevalence of diagnostic discordance between the specimens with and without calcifications revealed a higher value of calcified specimens in diagnosing high-risk and malignant calcifications.

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Section: Discussionmentioning

confidence: 52%

Value of stereotactic 11-gauge vacuum-assisted breast biopsy in non-palpable suspicious calcifications: an eight-year single institution experience with 587 patients

Yang

et al. 2020

Gland Surg

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“…In our cohort, we used 8 G for VAEs and 11 G for VABs. den Dekker et al found that six 9 G VAB specimens are enough to reach a final histopathological diagnosis in 95% of cases [12]. In our practice, we always aim to take 12 specimens for VAB and between 12-20 specimens for VAE to achieve complete excision.…”

Section: Discussionmentioning

confidence: 97%

Vacuum-Assisted Breast Biopsy System: No Innovation Without Evaluation

Monib¹,

Mukerji²,

Narula³

2021

Cureus

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Background Vacuum-assisted breast biopsy (VABB) has recently been gaining more popularity as a modality to reach the final diagnosis, especially in indeterminate breast lesions, resulting in a decreased number of surgical interventions and unnecessary follow-ups. Objective While our primary aim was to look into the outcomes of the VABB technique, our secondary aim was to assess the impact of the method on changes in patients' management. Patients and methods This study was a retrospective database analysis of vacuum-assisted biopsies (VABs) carried out at our breast unit during the period between January 2011 and January 2018. All our cases were image-guided; the caliber of vacuum-assisted needles used was 8 gauge (G) and 11 G. Patient demographics, lesion characteristics, and outcomes were retrieved from patients' notes and the hospital database. Results A total of 122 female patients were included in the analysis, out of whom 41.8% (51 patients) were screendetected, and 58.1% (71 patients) were symptomatic presentations. The mean lesion size on imaging was 14.8 mm (SD: 12.6); 50% (61 patients) had stereotactic vacuum-assisted breast biopsy (SVAB), and 50% (61 patients) had ultrasound-guided vacuum-assisted breast biopsy (US-VAB). Post-procedure histology was upgraded in 19.6% (24 patients), downgraded in 18.8% (23 patients), and remained unchanged in 61.4% (75 patients). Conclusion VABB is a safe and efficient procedure for the diagnosis and management of indeterminate and suspicious breast lesions. It provides an adequate amount of tissue, which can help in upgrading or downgrading histopathologically diagnosed patients, thereby decreasing the need for surgery.

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“…In VAB, the number of specimens to be collected will be directly proportional to the size of the lesion. Dekker et al ( 1 ) suggested the following: obtain six specimens with a 9G needle, from the lesion and from the periphery, in order to have 95% accuracy in the final diagnosis. In VAE, oblique aspiration should be avoided; rather, the lesion should be removed orthogonally, in order to obtain the largest possible specimen, which is an important factor in determining the number of atypical features in the lesion, given that the histological criterion to differentiate atypical ductal hyperplasia from ductal carcinoma in situ is quantitative and has the aim of reducing the rate of diagnostic underestimation.…”

Section: Technical Considerationsmentioning

confidence: 99%

“…Since then, VAE has been ever more widely used in clinical practice. The greater acceptance and broader availability, together with the use of larger caliber needles, has allowed the removal of a larger amount of sample, substantially reducing the rate of diagnostic underestimation and thus increasing the reliability of the results of the procedure ( 1 ) . This results in potential surgical de-escalation, reducing the extent of the surgical intervention in selected cases, and gains strength in a scenario in which the aim is to reduce costs, as well as the rates of underestimation and overtreatment, without compromising the quality of patient care.…”

Section: Introductionmentioning

confidence: 99%

Vacuum-assisted excision of breast lesions in surgical de-escalation: where are we?

Miranda

Bitencourt

2023

Radiol Bras

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Vacuum-assisted excision of breast lesions has come to be widely used in clinical practice. Increased acceptance and availability of the procedure, together with the use of larger needles, has allowed the removal of a greater amount of sample, substantially reducing the surgical upgrade rate and thus increasing the reliability of the results of the procedure. These characteristics result in the potential for surgical de-escalation in selected cases and gain strength in a scenario in which the aim is to reduce costs, as well as the rates of underestimation and overtreatment, without compromising the quality of patient care. The objective of this article is to review the technical parameters and current clinical indications for performing vacuum-assisted excision of breast lesions.

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Stereotactic 9-gauge vacuum-assisted breast biopsy, how many specimens are needed?

Cited by 11 publications

References 30 publications

Value of stereotactic 11-gauge vacuum-assisted breast biopsy in non-palpable suspicious calcifications: an eight-year single institution experience with 587 patients

Value of stereotactic 11-gauge vacuum-assisted breast biopsy in non-palpable suspicious calcifications: an eight-year single institution experience with 587 patients

Vacuum-Assisted Breast Biopsy System: No Innovation Without Evaluation

Vacuum-assisted excision of breast lesions in surgical de-escalation: where are we?

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