Stereotactic vacuum-assisted breast biopsy: results, follow-up and correlation with radiological suspicion.
OBJECTIVE
The purpose of this study was to assess the accuracy and clinical usefulness of stereotactic vacuum-assisted biopsy (VAB) for diagnosing suspicious, nonpalpable, only mammographically detectable breast lesions.


METHODS
We retrospectively evaluated the results of percutaneous stereotactic VAB with 11-gauge needles performed over a period of 34 months on 228 nonpalpable suspicious breast lesions detectable on mammography only [Breast Imaging Reporting and Data System (BI-RADS) 3: 25.9%; BI-RADS 4: 67.1%; BI-RADS 5: 7%]. The imaging histological concordance was ascertained for each lesion. In cases of discordance, repeat biopsy or surgical excision were recommended; in cases of benign lesions, we urged a follow-up of at least 6 months and for borderline and malignant lesions a surgical excision. We also evaluated concordance between VAB results and subsequent examinations (surgical excision or followup).


RESULTS
VAB demonstrated 123 (54%) benign lesions (with six cases of imaging-histological discordance), 26 (11.4%) borderline lesions and 79 (34.6%) malignant lesions. We obtained a suitable post-VAB mammographic or histological evaluation for 78 benign lesions, 17 borderline lesions and 76 malignant lesions, with one (1.3%) false negative (FN) case, two (11.8%) underestimations of borderline lesions, 14 (18.4%) underestimations of malignant lesions and no (0%) false positive cases. We did not observe any postbiopsy complications or scars.


CONCLUSIONS
Percutaneous histological VAB with an 11-gauge needle proved to be, as reported in previous studies, a reliable method for diagnosing nonpalpable, mammographically detectable only breast lesions, with an underestimation rate lower than core biopsy and a FN rate similar to that of surgical biopsy, without any significant complications.
Zuiani
C
C
Istituto di Radiologia, Università degli Studi di Udine, Via Colugna 50, I-33100, Udine, Italy. chiara.zuiani@med.uniud.it
Mazzarella
F
F
Londero
V
V
Linda
A
A
Puglisi
F
F
Bazzocchi
M
M
D001707:Biopsy, Needle / Q000379:methods*; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis; D018275:Carcinoma, Lobular / Q000175:diagnosis; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008327:Mammography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013238:Stereotaxic Techniques; D014618:Vacuum