Stereotactic vacuum‐assisted breast biopsy in 2874 patients

Abstract

BACKGROUND Vacuum‐assisted breast biopsy (VAB) can replace surgical biopsy for the diagnosis of breast carcinoma. The authors evaluated the accuracy and clinical utility of VAB in a multicenter setting using a strict quality assurance protocol. METHODS In the current study, VABs were performed successfully for 2874 patients at 5 sites. Benign lesions were verified by follow‐up. Surgery was recommended for malignant and borderline lesions. VAB was performed on patients with lesions rated as highly suspicious (6%), intermediate to suspicious (85%), or probably benign (9%). Fifty‐eight percent of the lesions were < 10 mm and 70% had microcalcifications. RESULTS The authors identified 7% of patients with invasive carcinomas, 15% with ductal carcinomas in situ (DCIS), 5% with atypical ductal hyperplasias (ADH), and 0.6% with lobular carcinomas in situ. The results of the VAB necessitated an upgrade of 24% of patients with ADH to DCIS or DCIS and invasive carcinoma. Twelve percent of patients with DCIS proved to have invasive carcinoma. Seventy‐three percent of the patients had benign lesions. Only 1 false‐negative result was encountered (negative predictive value, 99.95%). Minor side effects were reported to occur in 1.4% of patients and 0.1% of patients required a subsequent intervention. Scarring relevant for mammography was rare among patients (i.e., 0.3% of patients had relevant scarring). CONCLUSIONS Quality‐assured VAB was found to be highly reliable. VAB effectively identified patients with benign lesions and assisted therapeutic decisions. Most important, only a single case of malignancy was missed. A close interdisciplinary approach assured optimal results. Cancer 2004;100:245–51. © 2003 American Cancer Society.

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

“…Underestimation rates are lower for VABB than for core needle biopsy (11%-35% vs. 44%-56%, respectively) (11). Although upgrade to malignancy is lower compared to core biopsy, it is still possible even if all mammographic calcifications have been removed.…”

Histology after lumpectomy in women with epithelial atypia on stereotactic vacuum-assisted breast biopsy

“…In addition, extinction of the radiological signal after percutaneous biopsy, which occurs in 58% to 93% of cases when the radiological abnormality measures less than 5 mm, corresponds to complete excision on histological examination in only 6% to 18% of cases [22]. After percutaneous biopsy, it is important to ensure that the clinical, radiological and histological findings are coherent.…”

“…Lobular neoplasia, which is revealed by microcalcification in at least one-third of cases, is less frequent than ADH in biopsy and surgical series [15][16][17][18][19][20][21][22][23][24][25]. The behaviour of lobular neoplasia (LN) is less well documented than that of ADH.…”

Vacuum-assisted biopsy and steroid therapy for granulomatous lobular mastitis: Report of three cases

“…Cincinnati, OH, USA), a relatively non-invasive and safe procedure, has become popular in the last decade. 9,10 There is still no consensus on the optimal treatment for GLM, although wide excision of the breast mass seems to be the procedure of choice.…”