Stereotactic breast biopsy with an 8-gauge, directional, vacuum-assisted probe: initial experience.
This study was prospectively conducted to assess the feasibility, safety and accuracy of an 8-G directional vacuum-assisted biopsy (DVAB) probe in the diagnostic management of nonpalpable breast lesions (NPBL). Of 170 planned procedures which were indicated for investigation of BI-RADS category-3 to category-5 lesions, 153 were performed in 138 consecutive patients. The probe was targeted by the stereotactic unit of a prone table (United States Surgical Corporation, Norwalk, Conn.; and Lorad, Danbury, Conn.). Four to 18 (mean 8) core specimens were obtained for each lesion. In case of complete removal of the lesion, a localizing clip was deployed at the biopsy site. Adequate material for histopathologic examination was obtained in all cases (100%). Four of 138 (3%) patients experienced mild hematomas. We observed 15 of 39 failures (38%) to place the localizing clips. Thirteen of 153 (8%) procedures were inconclusive and required reintervention. Following DVAB, 42 of 138 (30%) patients underwent surgery. Subject to incomplete follow-up of the entire cohort, we observed no false-positive and one false-negative diagnosis. These preliminary results suggest that DVAB using an 8-G probe are feasible, safe and accurate. In our experience, clip placement was problematic. It is probable that increasing the dimensions of DVAB will only be relevant in a limited number of clinical situations, primarily the desire to obtain complete radiologic resections of the target abnormality.
Breast Department, University Hospital Sart Tilman, B35, 4000 Liège, Belgium. elifrange@chu.ulg.ac.be
Eric
E
Lifrange
Robert F
RF
Dondelinger
Pascale
P
Quatresooz
Geraldine
G
Vandevorst
Claude
C
Colin
D001706:Biopsy / Q000295:instrumentation / Q000379:methods*; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies