Stereotactic vacuum-assisted breast biopsy – experience with 545 patients

Abstract

Aims: Percutaneous vacuum-assisted core biopsy (VACB) is an image-guided technique for evaluation of non-palpable breast lesions and is an alternative to open surgical biopsy. Aim: The aim of our study was to assess the diagnostic value of VACB and to evaluate the rate and types of complications at our institution. Matherials and methods: In 18-month period, 545 patients were referred to VACB. The commonest radiological abnormalities were microcalcification in 80% and architectural distortion in 4%. Others were referred to VACB because of various breast masses. Complications associated with VACB were assessed at the time of the procedure and in post-procedure time, within 7 days. Results: The accuracy of this biopsy technique with 11-g needle for target lesion was over 97%. The average number of specimen was 10.8 (3–24). A total of 53% benign lesions, 16% borderline lesions, and 29% malignancies or DCIS were identified at final histology. In 191(35%) of patients surgery was performed after VACB. The results for VACB, with regard to predicting invasion, were: sensitivity 96.5%; specificity 95%; PPV 98.6% and NPV 89.3%. Complications at the time of procedure were low –1%, including bleeding and pain. In one-week period after the procedure, severe to moderate pain was reported by 38% of patients. Results: VACB was proven to be safe and highy accurate method in preoperative breast disease diagnosis. The majority of diagnostic excisions can be avoided.