Percutaneous removal of benign mammographic lesions: comparison of automated large-core and directional vacuum-assisted stereotactic biopsy techniques.

Abstract

RogerJ.FrancisA. Marzoni,Jr.2 KentW. Nowels3OBJECTIVE. The purposeof our studywas to evaluatehow often histologicallybenign lesions were completely removed as shown by the initial mammogram after biopsy. We corn pared three percutaneousbiopsy techniques.MATERIALS AND METHODS. Retrospective review wasperformedon 1206 consec utive impalpable breast lesions having percutaneous stereotactic biopsies done on a prone bi opsy table using 14-gauge automated large-core needles (n = 721); 14-gauge directional vacuum-assisted probes (n = 192); and 1I-gauge directional vacuum-assisted probes (n = 293). Lesions that were histologically benign and that did not have subsequent surgical cxci sion had mammographic follow-up. The 667 initial mammograms after biopsy (advised to be doneat 6 or 12 monthsand accomplishedat 1â€"53 months[median,7 months]after biopsy) were reviewed to see if the lesions were no longer apparent.RESULTS. The lesion was absentin 9% (40/422) of lesionsfor which 14-gaugelarge core biopsy was used, 22% (21/95) of lesions for which 14-gauge vacuum-assistedbiopsy was used, and 64% (96/150) of lesions for which I I-gauge vacuum-assisted biopsy was used

Imaging–histologic discordance at percutaneous breast biopsy

“…We found a significantly lower frequency of imaging-histologic discordance among calcific lesions that had 11-gauge directional vacuumassisted biopsy rather than 14 -gauge vacuum or automated core biopsy (7 of 414 ϭ 1.7% vs. 17 of 251 ϭ 6.8%; P ϭ 0.001). The lower frequency of discordance among calcific lesions that had 11-gauge directional vacuum-assisted biopsy likely reflects the improved calcification retrieval, 38,39 the larger volume of tissue removed, 40 and the higher frequency of complete excision of the mammographic target 15,16 with this method.…”

“…15,16 Specimen radiography can provide evidence that tissue was retrieved from the appropriate site during percutaneous biopsy of calcification lesions 17,18 but is less helpful for masses. 19 Postbiopsy mammography may reveal changes at the biopsy site, 20,21 but there is often no substantial alteration in the target lesion, particularly if the biopsy is performed with a smaller tissue acquisition device such as the 14-gauge automated needle.…”

Borderline breast lesions: comparison of malignancy underestimation rates with 14-gauge core needle biopsy versus 11-gauge vacuum-assisted device

“…This biopsy device uses a "vacuum suction" mechanism to retrieve the core specimens and to remove blood from bioptic cavity, potentially allowing a more complete sampling of the target-lesion and a lower chance of sampling error with consequent reduced false-negative diagnosis. Occasionally it is possible to obtain the complete or near complete removal of small mammographic abnormalities, although this does not ensure that the pathological lesion has been entirely excised [34,35]. The vacuum-assisted device has brought several advantages to the performance of stereotactic breast biopsy, in terms of decrease of rebiopy rate (the reasons for a second biopsy may include insufficient sampling, imaging-histologic discordance, pathologist recommendation or uncommon high-risk lesions) [16].…”

A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme

“…15 The false-negative rate in needle core biopsies from benign radial scars that contain malignancy on excision biopsy varies from 3.9% 5 to 40%. 16 As a result of these problems, excision biopsy should be carried out on all needle core biopsy diagnosed radial scars.…”