title: Vacuum-assisted breast biopsy under ultrasonographic guidance: analysis of a 10-year experience.
abstract: OBJECTIVE
  To determine the indications and the diagnostic accuracy of vacuum-assisted breast biopsy (VABB) under ultrasonographic (US) guidance based on a 10-year period of clinical use.
  
  
  METHODS
  This was a retrospective analysis of 2,920 breast lesions in 2,477 consecutive patients who underwent US-guided VABB between February 2002 and December 2011. The proportions of each indication for VABB were analyzed as well as the trend of its use over divided time periods. Histopathological diagnosis and the malignancy rate of the lesions with VABB were analyzed. A comparison of the pathological diagnosis of VABB and the gold standard diagnosis revealed the false negative rate, the underestimation rate, and the agreement rate.
  
  
  RESULTS
  Palpable lesions (44.4%), low-suspicion lesions (15.7%), high-risk lesions (12.4%), and calcifications (10.3%) were the most common indications for US-guided VABB. The malignancy rate of lesions submitted to VABB was 5.4%. The false negative rate was only 0.1%, while the underestimation rate of high-risk lesions and ductal carcinoma in situ was 3.1% and 13.8%, respectively, with a 98.7% agreement rate. Among 1,512 therapeutic VABB cases, 84.9% showed no residual or recurrent lesions on long term follow-up US for more than a year. Complications occurred in 1% of the patients without need for surgical intervention.
  
  
  CONCLUSIONS
  US-guided VABB is an accurate and safe method that can help decision-making in the diagnostic process and can be an alternative for excisional surgery in some therapeutic circumstances.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung Hyun
authors.identifier: 0000-0003-4602-0798
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eun-Kyung
authors.identifier: 0000-0002-3368-5013
authors.initials: EK
authors.lastname: Kim
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Min Jung
authors.identifier: 0000-0003-4949-1237
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hee Jung
authors.identifier: 0000-0002-5643-5885
authors.initials: HJ
authors.lastname: Moon
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung Hyun
authors.identifier: 0000-0002-2100-3513
authors.initials: JH
authors.lastname: Yoon
keywords: Breast; Breast neoplasms; Image-guided biopsy; Ultrasonography