Stereotactic vacuum-assisted breast biopsy: our experience and comparison with stereotactic automated needle biopsy

Abstract

Abstract:Objectives: To evaluate and compare the outcome of stereotactically guided percutaneous, directional, vacuum-assisted breast biopsy (VAB) with the outcome of those performed with 14-gauge automated gun. Methods: Between January 2008 and January 2011, altogether 257 stereotactic biopsies were performed in our institute; 193 with the 14-gauge automated needle and 64 with a directional, vacuum-assisted instrument. Patients with malignant or high risk lesions were encouraged to undergo an excisional biopsy. We evaluated and compared concordance between the biopsy results and subsequent examinations (surgical excision or follow up) for both methods. Results: VAB demonstrated 57 (89 %) benign lesions, 2 (3 %) high risk and 5 (8 %) malignant lesions. We obtained post-bioptic mammographic or histological evaluation for altogether 51 lesions, with one (12.5 %) false negative case, one case of underestimation of borderline lesion, and no false positive cases. Clusters of microcalcifi ation were completely removed in 18 lesions (28 %). Conclusion: Vacuum-assisted biopsy outperformed the 14-gauge automated needle biopsy with a lower disease underestimation, sensitivity and false-negative rates; however these differences were not statistically significant due to small data fi les and relatively small number of identifi ed malignant lesions in the vacuum-assisted biopsy group. VAB completely removed signifi cantly more clusters of microcalcifi cations in comparison to the automated needle biopsy, which signifi cantly reduced the need for surgery in benign lesions (Tab. 7, Fig. 3, Ref. 32). Full Text in PDF www.elis.sk.

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

“…Among the advantages of this method are its minimallyinvasive approach, uncomplicated application, quick results, low cost, reliability and enabling improvement (Domeyer et al, 2013;Tothova et al, 2013). Through the widespread promotion of national breast cancer screening programs and increase in breast cancer awareness, millions of women are having mammographies each year where a number of suspicious lesions are identified.…”

“…However, microcalcification clusters and parenchymal distortions detected in mammography cannot always be visualized in the ultrasound images. Therefore, a method of stereotactic vacuum-assisted core (SVC) biopsy has come into use for histopathologic diagnosis of these lesions (Tothova et al, 2013). Through the extensive use of mammography in screening for breast cancer, widespread national breast cancer screening programs, and the increase in breast cancer awareness, non-palpable suspicious lesions are being detected more frequently (NHS Breast Screening Programme, 2009;Dogan et al, 2012;Wang et al, 2012;Fouladi et al, 2013;Uyeturk et al, 2013;Avci et al, 2014).…”

The role of fine needle aspiration cytology and core biopsy in the diagnosis of palpable breast masses

“…8 23 24 On the other hand, the diagnosis of ductal carcinoma in situ (DCIS) is difficult with core biopsies. 25 The diagnostic difficulties associated with DCIS are due to several factors: Typically presenting as calcifications, often impalpable, and subtle form of breast cancer. The underestimation rate for diagnosis of DCIS by core biopsy varied from 26% to 78%.…”

“…The underestimation rate for diagnosis of DCIS by core biopsy varied from 26% to 78%. 25 26 We cannot evaluate the relationship between DCIS and core biopsy because of the small number of patients with DCIS. The complications of core biopsies are well defined in the literature, and these complications are bleeding, hematoma, mastitis, pneumothorax, vasovagal reaction, and rarely pseudoaneurysm and milk fistulization.…”