Minimizing underestimation rate of microcalcifications excised via vacuum-assisted breast biopsy: a blind study

Abstract

This recently introduced, "extended" way of performing VABB in microcalcifications safely minimizes the underestimation rate, which may lead to a modified management of ADH lesions.

Diagnosing Papillary Lesions Using Vacuum-Assisted Breast Biopsy: Should Conservative or Surgical Management Follow?

“…This occurred in most cases of our material. This phenomenon has been reported in the worldwide bibliography [18][19][20][21] for ADH, LN and carcinoma, but the effects of VABB performance (offsets, cores, volume excised) have not been consistently examined as far as papillary lesions are concerned. In conclusion, it may be said that after diagnosing a coexisting papillary lesion with a precursor breast lesion (ADH, LN, radial scars) using the VABB technique and pinpointing the spot with a hook-wire, open surgery should follow, given the high probability of a postoperative cancer diagnosis.…”

“…However, even though the use of VABB is very appealing, its underestimation rate appears to be its weak point. Studies that propose the excision of more core specimens, offsets and tissue volume seem to have produced appealing results as far as the minimization of atypical ductal hyperplasia (ADH), lobular neoplasia (LN) and ductal carcinoma in situ (DCIS) underestimation rate is concerned [18][19][20][21]. Surprisingly enough, only a few studies exist in the worldwide bibliography concerning papilloma diagnosis via VABB.…”

“…Both of them suggested that larger specimens extracted by VABB devices can improve the accuracy of a papillary lesion diagnosis and reported an underestimation rate in their material of 7% (2/30 patients). The extended VABB protocol adopted, in which the use of 1 main and 7 peripheral offsets as well as the excision of 96 cores lead to the excision of a larger volume, has safely diminished the underestimation rate as far as ADH, LN and DCIS are concerned [18][19][20][21]. The large number of cores (up to 96) excised from most patients of our study population may have been the reason of our better results in diagnosing papillary lesions.…”

Vacuum-Assisted Aspiration Biopsy: Minimally Invasive Treatment for Benign Breast Tumors (A Literature Review)

“…[17], не замечено связи между полнотой иссе-чения фиброаденом и размером используемых игл (G8 или G11). Основным недостатком метода ВАБ являет-ся недооценка атипичной протоковой гиперплазии, лобулярной неоплазии и протоковой карциномы in situ, однако иссечение большего числа ядер (участ-ков) во время ВАБ из зоны интереса снижает уровень недооценки [18,19].…”

Sampling lobular neoplasia of the breast: underestimation despite technical success?

“…The underestimation rate in our setting was significantly lower than the overall underestimation rate reported by Menon et al (two of 33 vs. nine of 25; p= 0.006, Fisher's exact test). The above may be attributed to more accurate targeting of the lesion through the stereotactic guidance, as well as to the greater number of cores excised (24-96 cores, according to the results of a doubleblind study [3]). These two factors might effectively reduce the technical failure rate.…”