Stereotactic biopsy of the breast using an upright unit, a vacuum-suction needle, and a lateral arm-support system.
OBJECTIVE
This study evaluated the vacuum-suction needle (8- to 11-gauge) on an upright stereotactic machine with a lateral arm-support system.


METHODS
From July 1999 to August 2000, 185 core biopsies of the breast in 179 consecutive patients were planned in four institutions using 8- 11-gauge vacuum-suction probes on an upright stereotactic unit. Needles were stabilized and attached to the x, y, and z coordinates of the machines via a lateral arm-support system. Needle entry was made in the x-axis.


RESULTS
Five patients were canceled, and 180 biopsies were performed in 174 patients while the patients were in seated (n = 171) and lateral decubitus (n = 9) positions. An average of 9.5 cores were taken (range, 5-26 cores). Targeting was successful in 176 (98%) of 180 cores. Lesions were missed because of movement associated with Parkinson's disease (n = 1), or because the mass was obscured (n = 1) or calcifications were not in the core specimen (n = 2). Findings in 152 (84%) of the biopsies were benign and 28 (16%) were malignant. Forty-one lesions underwent surgical excision and 106 underwent mammographic follow-up. Discordance was 4% (6/147). Complications included vasovagal reactions (n = 10, 5.6%), bleeding (n = 5, 3%), hematomas (n = 3, 1.7%), vomiting (n = 1, 0.6%), and technical failure (n = 1, 0.6%).


CONCLUSIONS
Vacuum-suction needle core biopsies can be successfully performed on an upright stereotactic machine with a lateral arm attachment. Thinly compressed breasts and lesions located near the chest wall are well sampled. The vasovagal rate is higher than that on a prone table but is acceptable.
Georgian-Smith
Dianne
D
Department of Radiology, University of Washington Medical Center, Box 375115, 1959 N. E. Pacific, Seattle, WA 98195, USA.
D'Orsi
Carl
C
Morris
Ellen
E
Clark
Crandon F
CF
Liberty
Ellen
E
Lehman
Constance D
CD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D015641:Radiography, Interventional; D013238:Stereotaxic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D014618:Vacuum