Stereotactic breast biopsy of clustered microcalcifications with a directional, vacuum-assisted device.

Meyer, Jack E.; Smith, Dietrich C.; DiPiro, Pamela J.; Denison, Christine M.; Frenna, T H; Harvey, Susan C.; Ko, William D.

doi:10.1148/radiology.204.2.9240556

Cited by 103 publications

(61 citation statements)

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“…Still, the number of included ADH cases was insufficient to make a reliable comment on underdiagnosis. In previous studies, underestimation rates for carcinoma ranged between 18% and 20% (9,(27)(28)(29)(30)(31). Our results are comparable with the literature for carcinoma underestimations using DCIS.…”

Section: Discussionsupporting

confidence: 88%

Vacuum-assisted stereotactic biopsy for isolated BI-RADS 4 microcalcifications: evaluation with histopathology and midterm follow-up results

Atasoy

Tasalı²,

Çubuk³

et al. 2015

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE The aim of this study was to evaluate the 10-gauge vacuum-assisted stereotactic biopsy (VASB) of isolated Breast Imaging Reporting and Data System (BI-RADS) 4 microcalcifications, using histology and follow-up results. METHODSFrom January 2011 to June 2013, VASB was performed on 132 lesions, and 66 microcalcification-only lesions of BI-RADS 4 were included into our study. VASB was performed using lateral decubitis stereotaxy for all patients. Pathologic results of VASB and further surgical biopsies were reviewed retrospectively. Patients who were diagnosed to have benign lesions by VASB were referred for follow-up. VASB and surgical histopathology results were compared to determine the underestimation ratios. RESULTSFifteen out of 66 lesions from 63 patients (median age, 47 years; range, 34-88 years) were identified as malignant by VASB. Pathological results after surgery revealed three cases of invasive ductal carcinoma among the 12 VASB-diagnosed ductal carcinoma in situ (DCIS) lesions, for a DCIS underestimation rate of 25%. The atypical ductal hyperplasia underestimation rate was 0% for the three lesions. The follow-up period was at least 10 months, with an average of 22.7 months for all patients and 21.2 months for patients with VASB-diagnosed benign lesions. None of the patients had malignancy during the follow-ups. The false-negative rate was 0% in the follow-up of 48 patients. CONCLUSION VASB should be the standard method of choice for BI-RADS 4 microcalcifications. This method obviates the need for a surgical procedure in 73% of BI-RADS 4 microcalcification-only patients.

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Section: Discussionsupporting

confidence: 88%

Vacuum-assisted stereotactic biopsy for isolated BI-RADS 4 microcalcifications: evaluation with histopathology and midterm follow-up results

Atasoy

Tasalı²,

Çubuk³

et al. 2015

Diagn Interv Radiol

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“…This technique uses only one puncture, with the probe of the device remaining within the breast, at the site of interest, throughout the sampling. Meyer et al (8) showed 90.8% of microcalcifications in samples obtained using standard automated needle devices compared with 95%-100% of microcalcifications in samples extracted by the vacuum-assisted device (19,20). Accordingly, in our series, microcalcifications were identified in specimen radiographs of 98.5% of lesions.…”

Section: Discussionmentioning

confidence: 44%

“…It is particularly advantageous in the assessment of calcified lesions (7)(8)(9)(10)(16)(17)(18). This technique uses only one puncture, with the probe of the device remaining within the breast, at the site of interest, throughout the sampling.…”

Section: Discussionmentioning

confidence: 99%

Vacuum-assisted stereotactic breast biopsy in the diagnosis and management of suspicious microcalcifications

Esen

Tutar²,

Uras³

et al. 2016

Diagn Interv Radiol

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C urrently, the gold standard for breast biopsies is open excision of the suspected lesion. However, an excisional biopsy inevitably leaves a scar behind. The cost and morbidity associated with this procedure have prompted many physicians to evaluate less invasive and alternative procedures (1-3).Clustered suspicious microcalcifications can be a very early sign of malignancy, particularly typical for ductal carcinoma in situ (DCIS). Microcalcifications are usually detected on screening mammographies, and most of them cannot be identified on ultrasonography (US). Lesions detected only on mammography require stereotactic guidance for biopsy, and vacuum-assisted breast biopsy (VABB) is currently the biopsy method of choice for stereotactic biopsies. VABB is considered to be a safe procedure and is comparable to surgical biopsy for the characterization of microcalcifications (4, 5). Studies have shown that it is a very accurate biopsy method and is characterized by high-quality specimens, high calcification retrieval, and low rates of false-negative results (6-10). In case of microcalcifications, complete percutaneous excision is frequently possible, which leads to a decrease in sampling error as well as a decrease in upgrade rate, imaging-pathology discordance, and re-biopsy rate. The likelihood of subsequent growth on follow-up is also diminished. VABB is not a therapeutic procedure for malignant lesions; however, using VABB for diagnosis rather than surgical biopsy decreases the number of operations required (11-13).Vacuum biopsy can be used for the histopathologic diagnosis of all nonpalpable breast lesions; however, it is mostly reserved for mammographically detected lesions, mainly mi- BREAST IMAGING O R I G I N A L A R T I C L E PURPOSEWe aimed to present our biopsy method and retrospectively evaluate the results, upgrade rate, and follow-up findings of stereotactic vacuum-assisted breast biopsy (VABB) procedures performed in our clinic. METHODSTwo hundred thirty-four patients with mammographically detected nonpalpable breast lesions underwent VABB using a 9 gauge biopsy probe and prone biopsy table. A total of 195 patients (median age 53 years, range 32-80 years) with 198 microcalcification-only lesions with a follow-up of at least one year were included in the study. The location of the lesion relative to the needle was determined from the postfire images, and unlike the conventional technique, tissue retrieval was predominantly performed from that location, followed by a complete 360° rotation, if needed. RESULTSThe median core number was 8.5. Biopsy results revealed 135 benign, 24 atypical, and 39 malignant lesions. The total upgrade rate at surgery was 7.7% (6.1% for ductal carcinomas in situ and 10.5% for atypical lesions). Patients with benign lesions were followed up for a median period of 27.5 months, with no interval change. At the follow-up, scar formation was seen in 23 patients (17%); three of the scars were remarkable for resembling a malignancy. CONCLUSIONOur biposy method is fast and practica...

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“…A failure occurred only in one case with the EnCor ® probe. However, this finding cannot be attributed to the system used, since failure rates between 0 and 5 % with Mammotome ® system in previous studies have been described [21][22][23].…”

Section: Discussionmentioning

confidence: 80%

Mammotome® and EnCor®: comparison of two systems for stereotactic vacuum-assisted core biopsy in the characterisation of suspicious mammographic microcalcifications alone

et al. 2014

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the lesions. The two systems did not differ statistically for correlation with the final histology (S1 k = 0.94 ± 0.06; S2 k = 0.92 ± 0.08) and underestimation of B3 lesions or in situ (S1 4.5 %; S2 4.3 %). Sensitivity, specificity, PPV, NPV, diagnostic accuracy of S1 and S2 were also not statistically different. The systems differed only in sampling time (S1 80; S2 63 s), but not in total procedure time. Conclusions Our study confirms the effectiveness of VABB in the assessment of microcalcifications and highlights the lack of significant differences between the two systems in terms of diagnostic performance.

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Stereotactic breast biopsy of clustered microcalcifications with a directional, vacuum-assisted device.

Cited by 103 publications

References 0 publications

Vacuum-assisted stereotactic biopsy for isolated BI-RADS 4 microcalcifications: evaluation with histopathology and midterm follow-up results

Vacuum-assisted stereotactic biopsy for isolated BI-RADS 4 microcalcifications: evaluation with histopathology and midterm follow-up results

Vacuum-assisted stereotactic breast biopsy in the diagnosis and management of suspicious microcalcifications

Mammotome® and EnCor®: comparison of two systems for stereotactic vacuum-assisted core biopsy in the characterisation of suspicious mammographic microcalcifications alone

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