Initial Experience of Tomosynthesis-Guided Vacuum-Assisted Biopsies of Tomosynthesis-Detected (2D Mammography and Ultrasound Occult) Architectural Distortions

Abstract

Tomosynthesis-guided VAB is a feasible method to sample ADs that are occult at 2D mammography and ultrasound. Tomosynthesis-guided VAB is a minimally invasive method that detected a significant number of carcinomas, most of which were grade 1 cancers. Further studies are needed.

Malignant Outcomes of Architectural Distortion on Tomosynthesis: A Systematic Review and Meta-Analysis

“…If and when to biopsy AD seen on DBT has been questioned. Recent studies [15][16][17][18][19][20][21][22][23][24][25][26][27] examining AD on DBT included small numbers of patients, ranging from 14-274 patients, and described varying rates of malignancy. Hence, a thorough assessment is needed of rates of malignancy in AD detected on DBT.…”

“…diagnostic mammography [15,16,19,21,[23][24][25][26], 3 on screening only [18,22,27], and 1 on diagnostic only [17];1 study did not clearly define the initial mode of presentation [20] (Table 1).…”

“…Three studies excluded AD with any associated findings (masses, asymmetries, and calcifications) [15,17,27]. One study included lesions with all associated findings [18], 3 studies did not specify if associated findings were included [20,25,26], and the remaining studies included AD with some associated findings and excluded AD with other associated findings [16,19,[21][22][23][24] (Table 1).…”

Tomosynthesis guided core biopsy of breast lesions – method review and our results

“…Kod stereotaksijskih biopsija osobit je problem cilja nje promjena bez kalcifikata, kao što su tvorbe i pore mećaji strukture, koje često nisu dobro vidljive iz razli čitih kutova snimanja te ih je teško obilježiti za potrebe triangulacije, što dovodi do ponavljanja snimanja. 32,35,36 S obzirom na to da su dodatna snimanja kod biopsija vođenih tomosintezom izbjegnuta, trajanje procedure bitno je kraće zbog brže reidentifikacije promjene. Prema literaturi, postupak biopsije dojke vođene to mosintezom prosječno traje otprilike polovicu vre mena potrebnoga za stereotaksijsku biopsiju.…”

“…U drugim studijama našli smo po datke o udjelu malignih nalaza dobivenih biopsijom vođenom mamografski od 21 do 55%. 10,33,36,[49][50][51] Ovi postotci uvelike ovise o vrsti bioptiranih promjena, a u našem materijalu prevladavali su mikrokalcifikati, s čak 74%, dok su tvorbe bile zastupljene sa svega 12% (njih smo bioptirali uglavnom pod kontrolom ultra zvuka), što objašnjava ovakav rezultat. U jedne paci jentice s izrazito malenom promjenom, čiji je nalaz biopsije bio invazivni duktalni karcinom, kirurškim zahvatom nije nađen malignitet.…”