Percutaneous removal of benign mammographic lesions: comparison of automated large-core and directional vacuum-assisted stereotactic biopsy techniques.

Abstract

The purpose of our study was to evaluate how often histologically benign lesions were completely removed as shown by the initial mammogram after biopsy. We compared three percutaneous biopsy techniques. Retrospective review was performed on 1206 consecutive impalpable breast lesions having percutaneous stereotactic biopsies done on a prone biopsy table using 14-gauge automated large-core needles (n = 721); 14-gauge directional vacuum-assisted probes (n = 192); and 11-gauge directional vacuum-assisted probes (n = 293). Lesions that were histologically benign and that did not have subsequent surgical excision had mammographic follow-up. The 667 initial mammograms after biopsy (advised to be done at 6 or 12 months and accomplished at 1-53 months [median, 7 months] after biopsy) were reviewed to see if the lesions were no longer apparent. The lesion was absent in 9% (40/422) of lesions for which 14-gauge large-core biopsy was used, 22% (21/95) of lesions for which 14-gauge vacuum-assisted biopsy was used, and 64% (96/150) of lesions for which 11-gauge vacuum-assisted biopsy was used (p < .0001). No mammographic pseudolesions were created by the biopsy. No clinically significant complications occurred. The lesion was more often completely removed with directional vacuum-assisted biopsy than with automated large-core biopsy and more often completely removed with 11-gauge probes than with 14-gauge probes.