Comparison of vacuum biopsy systems

R Wilson

doi:10.1186/bcr2029

Abstract

More than 15 years ago breast radiologists recognised the limitations of fine-needle aspiration and core biopsy as methods for accurate percutaneous breast diagnosis and a variety of different devices were developed to retrieve larger needle biopsy specimens. Vacuum-assisted mammotomy (VAM) has been the most successful of these methods. While core biopsy remains the method of choice for routine needle breast biopsy, VAM is now in routine use as a proven method for minimising the sampling error of subtle and borderline breast lesions and for therapeutic excision of benign breast lesions as an alternative to surgery. VAM achieves significant 50% reduction in understaging of premalignant and malignant disease. VAM technology has been refined in recent years and there are now four different VAM devices available. All are designed for use under X-ray and ultrasound guidance. The third-generation devices are closed systems that use larger gauge probes to ensure that ample material can be rapidly acquired. The latest devices are designed to be used with both prone table and upright X-ray equipment, and are particularly suitable for lateral approach stereotactic biopsy. Sensitivity rates for invasive and in situ carcinoma of 95% to 100% are achievable and VAM should now be considered routine for most stereotactic biopsy procedures. VAM can also be used routinely in place of surgery for the excision of benign lesions and for confirmation excision of papillary lesions and radial scars. Comparative analyses of the current VAM devices will be presented.

Highlights

Breast-sparing oncoplastic procedures (BSOP) offer a predictive marker guiding use of anti-oestrogen therapy, and radical new alternative to mastectomy and conventional breast- expression profiling appears to select patients more or less likely to conserving surgery in early breast cancer treatment
The aim was to document attitudes to male radiographers and the effect on the programme performance parameters through a postal questionnaire completed by 85.8% of a random sample of 2,000 women recently screened by BreastCheck
Nine per cent would not have proceeded if the radiographer was male; 17.5% agreed that ‘If there were male radiographers I would not return for another screening appointment’; and 18.3% were unsure

Summary

Introduction

Breast-sparing oncoplastic procedures (BSOP) offer a predictive marker guiding use of anti-oestrogen therapy, and radical new alternative to mastectomy and conventional breast- expression profiling appears to select patients more or less likely to conserving surgery in early breast cancer treatment. We have compared the results of screening with analogue and digital technology over our first 2 years, in terms of recall rates, cancer detection rates and positive predictive value, and found no overall significant difference in any of these parameters. Abnormalities are graded as A, B or C at consensus by the radiologists and reporting radiographers depending upon the mammographic likelihood of cancer and biopsy This means that patients can be allocated to one of our three assessment clinics and at specific times within those clinics to facilitate workflow. Methods A retrospective analysis of all breast cancer patients with recurrence who had completed 5 years of follow-up was performed. Infection control is not routinely included in the quality assurance process of all units

Methods

Results

Conclusion