Comparison of Automated Versus Vacuum-Assisted Biopsy Methods for Sonographically Guided Core Biopsy of the Breast

Abstract

No significant differences were found in the outcomes of sonographically guided core biopsies performed with the automated gun compared with those performed with the vacuum-assisted device in terms of missed cancers, underestimation, complications, or the need (immediate or delayed) for a second biopsy.

Ultrasound-guided large-core needle biopsies of breast lesions: analysis of 962 cases to determine the number of samples for reliable tumour classification

“…Besides lesions that could undoubtedly be classified as benign or malignant, there is a fraction (termed histological underestimates) of histological findings allowing only an incomplete characterisation of the pathology. In this study, the LNCBbased diagnoses of the 11 DCIS (58%) underestimates for which subsequent analysis of the surgical specimen revealed invasiveness were higher than in other studies (Fishman et al, 2003;Philpotts et al, 2003;Pijnappel et al, 2004). Obviously, there is a certain small risk of misdiagnosing a DCIS lesion to be an ADH, or malignant lesions to consist only of ADH or LCIS (two in our study) on the basis of small samples, which indicates the need for an open surgical approach in ADH and DCIS-classified cases.…”

“…In all other cases with benign core biopsy results in accordance with US images, follow-up mammography or US examination at 3-month intervals was recommended in accordance with the results of previous studies (Parker et al, 1994;Philpotts et al, 2003).…”

“…Large-core needle biopsy is considered the gold standard procedure for diagnosis of palpable and nonpalpable breast lesions, preferred because it allows a characterisation of benign and malignant lesions by histological examination (Parker et al, 1994;Philpotts et al, 2003;Pijnappel et al, 2004). In comparison, fine-needle-aspiration (FNA) which yields a cytological specimen shows a higher percentage of inconclusive results up to 29% (Klijanienko et al, 1998).…”

“…Besides the comparison of different imaging tools, controversy has largely centred around reliability and reproducibility of this approach (Crowe et al, 2003b), the required amount of tissue, and the minimum number of samples which have to be evaluated for a reliable classification of breast lesions. Most authors suggest that five core specimens per lesion are required for exact tumour classification (Parker et al, 1994;Philpotts et al, 2003); however, this has not been universal practice in clinical routine. Several studies have addressed this question regarding stereotactic guidance and have determined five specimens to be required for a reliable tumour classification (Liberman et al, 1994;Brenner et al, 1996).…”

Scoring system for predicting malignancy in patients diagnosed with atypical ductal hyperplasia at ultrasound-guided core needle biopsy

“…However, there are few reports regarding ultrasound-guided procedures, and the benefit of vacuumassisted devices remains debatable. In a study of ultrasound-guided CNB, Philpotts et al [23] reported that there was no significant difference in outcomes when comparing 11-gauge vacuum-assisted devices with 14-gauge automated guns, while Grady et al [24] suggested that vacuum-assisted biopsy was more accurate than automated gun biopsy under ultrasound guidance. A possible explanation for the present results is that the 11-guage vacuumassisted biopsies incorporated a higher proportion of calcified lesions (18/24, 75%) compared to 14-gauge automated gun biopsies (14/50, 28%).…”