title: Complete removal of nonpalpable breast malignancies with a stereotactic percutaneous vacuum-assisted biopsy instrument.
abstract: BACKGROUND
  Several devices have been developed for sampling nonpalpable mammographic breast lesions. Complete removal of malignancies with a stereotactic percutaneous directional vacuum-assisted biopsy instrument has been reported.
  
  
  METHODS
  We reviewed our experience with the percutaneous vacuum-assisted biopsy instrument to identify instances of complete excision of cancers: no residual carcinoma found at surgical excision for malignancies diagnosed by the percutaneous vacuum-assisted biopsy instrument. The radiologic and pathologic characteristics of malignancies completely removed by the percutaneous vacuum-assisted biopsy instrument were compared with those of malignancies with residual carcinoma found at surgical excision.
  
  
  RESULTS
  Fifty-two malignancies were diagnosed by the percutaneous vacuum-assisted biopsy instrument: 16 infiltrating ductal carcinomas, 5 infiltrating lobular carcinomas, and 31 ductal carcinomas in situ. No residual carcinoma was found at surgical excision in 9 (17%) of the 52 malignancies. Patients with complete removal of the malignant lesion were younger than patients with incomplete removal (52 versus 58 years; p = 0.069). Completely removed malignancies were smaller on mammography (4 versus 17 mm; p = 0.213), and more specimens were removed (19 versus 15; p = 0.074). All nine completely removed malignancies presented with calcifications without a mass (p = 0.112), and all nine were ductal carcinoma in situ (p = 0.019).
  
  
  CONCLUSIONS
  Complete removal of nonpalpable breast malignancies is possible with the stereotactic percutaneous directional vacuum-assisted biopsy device. Complete removal is more likely with removal of a large number of specimens from small areas of mammographic calcifications due to ductal carcinoma in situ.
authors.affiliation: Department of Surgery, Mount Sinai Medical Center, New York, NY 10029, USA.
authors.forename: C
authors.initials: C
authors.lastname: Gajdos
authors.forename: M
authors.initials: M
authors.lastname: Levy
authors.forename: Z
authors.initials: Z
authors.lastname: Herman
authors.forename: G
authors.initials: G
authors.lastname: Herman
authors.forename: I J
authors.initials: IJ
authors.lastname: Bleiweiss
authors.forename: P I
authors.initials: PI
authors.lastname: Tartter
mesh_terms: D001706:Biopsy / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000473:pathology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008875:Middle Aged; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D016896:Treatment Outcome; D014618:Vacuum