Abstract
Core biopsy is now established as the first-line method for breast biopsy and sensitivity for carcinoma of 90–95% can be achieved. The quest for 100% accuracy of percutaneous biopsy has led to the development of very large core biopsy methods; vacuum assisted mammotomy (VAM) is the most successful and widely used of these methods. VAM is available in 14, 11 and 8 gauge sizes (36, 100 and 300 mg per core). The 8-g probe has been developed specifically for attempted complete removal of small breast lesions. VAM is not suitable for excision of malignant lesions but has a role in the removal for diagnosis of borderline lesions and removal of confirmed benign lesions at the patient's request. Borderline lesions suitable for VAM removal are papillary lesions, mucocele-like lesions and radial scars. Nipple discharge associated with intraduct papilloma can also be treated by this method. VAM can also be used to excise fibroadenomas up to 30 mm in diameter. VAM is well tolerated and has very few complications. For therapeutic excision VAM is significantly cheaper than surgical biopsy.
Highlights
Histological analysis of core biopsy of breast lesions takes a minimum of 24 h, but imprint cytology of a core biopsy can be reported within an hour
A total of 450,425 women were screened by BreastScreen Western Australia (BSWA) from January 1990 to December 2000. 2,314 cancers were detected with a total cancer detection rate of 5.1 cancers per 1,000 women screened. 4,916 women of ATSI origin were screened during this interval. 31 breast cancers were diagnosed, with a total cancer detection rate of 6.3 cancers per 1,000 women screened
These lesions may mimic the microcalcifications of ductal carcinoma in situ at screening mammography
Summary
Histological analysis of core biopsy of breast lesions takes a minimum of 24 h, but imprint cytology of a core biopsy can be reported within an hour. This study validates the accuracy of imprint cytology from core biopsy of breast lesions obtained under ultrasound control. Full field digital mammography (FFDM) seems set to replace conventional film-screen technique. Concern has been raised over FFDM diminished spatial resolution (5–6 Ip/mm). If valid, this could compromise detection of calcification and diagnosis of ductal carcinoma in situ (DCIS). In our centre we were not able to perceive any difference between microfocus magnification and on-screen magnification when assessing microcalcification. We subsequently compared these results with average scores for over 90 film-screen mammography systems
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