Abstract
BackgroundMammography-guided vacuum-assisted biopsies (MGVAB) can be done with stereotaxis or digital breast tomosynthesis guidance. Both methods can be performed with a conventional (CBA) or a lateral arm biopsy approach (LABA). Marker clip migration is relatively frequent in MGVAB (up to 44%), which in cases requiring surgery carries a risk of positive margins and re-excision. We aimed to compare the rates of clip migration and hematoma formation between the CBA and LABA techniques of prone MGVAB. Our HIPAA compliant retrospective study included all consecutive prone MGVAB performed in a single institution over a 20-month period. The LABA approach was used with DBT guidance; CBA utilized DBT or stereotactic guidance. The tissue sampling techniques were otherwise identical.ResultsAfter exclusion, 389 biopsies on 356 patients were analyzed. LABA was done in 97 (25%), and CBA in 292 (75%) cases. There was no statistical difference in clip migration rate with either 1 cm or 2 cm distance cut-off [15% for CBA and 10% for LABA for 1 cm threshold (p = 0.31); 5.8% or CBA and 3.1% or LABA for 2 cm threshold (p = 0.43)]. There was no difference in the rate of hematoma formation (57.5% in CDB and 50.5% in LABA, p = 0.24). The rates of technical failure were similar for both techniques (1.7% for CBA and 3% for LABA) with a combined failure rate of 1%.ConclusionsLABA and CBA had no statistical difference in clip migration or hematoma formation rates. Both techniques had similar success rates and may be helpful in different clinical situations.
Highlights
Mammography-guided vacuum-assisted biopsies (MGVAB) can be done with stereotaxis or digital breast tomosynthesis guidance
Stereotactic breast biopsies can be performed with conventional (CBA) or “lateral arm” (LABA) approach
lateral arm biopsy approach (LABA) is not associated with increased rate of hematoma formation
Summary
Mammography-guided vacuum-assisted biopsies (MGVAB) can be done with stereotaxis or digital breast tomosynthesis guidance. Both methods can be performed with a conventional (CBA) or a lateral arm biopsy approach (LABA). Stereotactic biopsy (SB) is a safe and effective method of sampling suspicious mammography (MG) detected non-palpable imaging findings that are not visible on Weaver et al Insights into Imaging (2021) 12:193 ultrasound [1–4]. It has become the standard of care for MG-only detected lesions, replacing surgical excisional biopsy [1, 5, 6]. This is possible due to the direct lesion depth determination, which does not depend on a triangulation process requiring visualization of the target on both stereotactic projections 30 degrees apart from each other [8–12]
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