title: Stereotactic vacuum-assisted breast biopsy in 2874 patients: a multicenter study.
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.
authors.affiliation: Department of Radiology, Mamma-Zentrum Klinikum Buch, HELIOS Klinikum Berlin, Wiltberg Strasse 50, HS 120, 13125 Berlin, Germany. ukettritz@berlin.helios-kliniken.de
authors.forename: Ute
authors.initials: U
authors.lastname: Kettritz
authors.forename: Kerstin
authors.initials: K
authors.lastname: Rotter
authors.forename: Ingrid
authors.initials: I
authors.lastname: Schreer
authors.forename: Margarete
authors.initials: M
authors.lastname: Murauer
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Schulz-Wendtland
authors.forename: Daniela
authors.initials: D
authors.lastname: Peter
authors.forename: Sylvia H
authors.initials: SH
authors.lastname: Heywang-Köbrunner
mesh_terms: D001706:Biopsy / Q000379:methods*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results