title: Mammographic characteristics and vacuum-assisted breast biopsy (VABB) of non-palpable breast lesions.
abstract: BACKGROUND
  The new imaging technology made available today allows for an early detection of small subclinical breast lesions which frequently call for guided presurgical micro-histology.
  
  
  OBJECTIVE
  To evaluate the relationship between vacuum-assisted breast biopsy (VABB) histopathological diagnoses and mammographic findings in non-palpable breast lesions.
  
  
  METHODS
  The breast lesions of 1393 women who had received consecutive screening mammograms between 2001 and 2007 were assessed by VABB. The mammographic breast lesions, classified according to the Breast Imaging Reporting and Data System (BI-RADS), were subjected to VABB only if rated as highly suspicious (2%), suspicious (64.5%) for malignancy, or probably benign (33.5%).
  
  
  RESULTS
  VABB findings included 981 (70.5%) probably benign lesions, 407 (29.2%) suspicious/malignant lesions, and five (0.3%) cases which were considered as inappropriate for diagnostic purposes. At histology, 10.2% of the suspicious/malignant lesions were classified as proliferative lesions, 11.1% as ductal carcinoma in situ (DCIS), and 8% as invasive ductal carcinoma (IDC). The positive predictive value (PPV) of BI-RADS assessment categories 3, 4 and 5 was 4.1%, 25.3% and 75%, respectively. The occurrence of obscured or spiculated masses was found to exhibit the highest PPV for malignancy (12.5% in BI-RADS 3 and 63% in BI-RADS 4), followed by microcalcifications which showed a malignancy rate of 6.4% in BI-RADS 3, and 20% in BI-RADS 4.
  
  
  CONCLUSIONS
  VABB turns out to be effective in the assessment of many malignant and benign preclinical tumour lesions thus allowing for a significant reduction of the number of surgical biopsies.
authors.affiliation: Women's Department, National Cancer Institute, Bari, Italy. ventrel@libero.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ventrella
authors.forename: Antonio
authors.initials: A
authors.lastname: Tufaro
authors.forename: Francesco A
authors.initials: FA
authors.lastname: Zito
authors.forename: Maria
authors.initials: M
authors.lastname: Addante
authors.forename: Baldassarre
authors.initials: B
authors.lastname: Stea
authors.forename: Rosalba
authors.initials: R
authors.lastname: Dentamaro
authors.forename: Cosimo
authors.initials: C
authors.lastname: D'Amico
authors.forename: Angelo
authors.initials: A
authors.lastname: Paradiso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008327:Mammography; D008875:Middle Aged; D010173:Palpation; D011237:Predictive Value of Tests; D019233:Retreatment / Q000706:statistics & numerical data; D014618:Vacuum