Abstract
PurposeTo compare the outcomes of ultrasound-guided core biopsy for non-mass breast lesions by the novel 13-gauge cable-free vacuum-assisted biopsy (VAB) and by the conventional 14-gauge semi-automated core needle biopsy (CCNB).Materials and methodsOur institutional review board approved this prospective study, and all patients provided written informed consent. Among 1840 ultrasound-guided percutaneous biopsies performed from August 2013 to December 2014, 145 non-mass breast lesions with suspicious microcalcifications on mammography or corresponding magnetic resonance imaging finding were subjected to 13-gauge VAB or 14-gauge CCNB. We evaluated the technical success rates, average specimen numbers, and tissue sampling time. We also compared the results of percutaneous biopsy and final surgical pathologic diagnosis to analyze the rates of diagnostic upgrade or downgrade.ResultsUltrasound-guided VAB successfully targeted and sampled all lesions, whereas CCNB failed to demonstrate calcification in four (10.3%) breast lesions with microcalcification on specimen mammography. The mean sampling time were 238.6 and 170.6 seconds for VAB and CCNB, respectively. No major complications were observed with either method. Ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) lesions were more frequently upgraded after CCNB (8/23 and 3/5, respectively) than after VAB (2/26 and 0/4, respectively P = 0.028).ConclusionNon-mass breast lesions were successfully and accurately biopsied using cable-free VAB. The underestimation rate of ultrasound-detected non-mass lesion was significantly lower with VAB than with CCNB.Trial registrationCRiS KCT0002267.
Highlights
Rapid and accurate diagnosis of suspected breast cancer lesions is highly important for both women with cancer and those without significant breast issues who require reassurance
Ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) lesions were more frequently upgraded after conventional 14gauge semi-automated core needle biopsy (CCNB) (8/23 and 3/5, respectively) than after vacuum-assisted biopsy (VAB) (2/26 and 0/4, respectively P = 0.028)
The underestimation rate of ultrasound-detected non-mass lesion was significantly lower with VAB than with CCNB
Summary
Rapid and accurate diagnosis of suspected breast cancer lesions is highly important for both women with cancer and those without significant breast issues who require reassurance. Percutaneous core needle biopsy, a rapid, cost-effective, highly sensitive, and highly specific method that facilitates definitive diagnoses and provides prognostic information, is considered standard practice, preventing the need for open surgical biopsy or frozen-section analysis [1]. Ultrasound (US) is the preferred first-line imaging modality for breast biopsy, and US-guided core biopsy is a cost-effective, rapid method that facilitates definitive diagnosis and provides prognostic information, allowing prompt decisions about future treatment options. The 14-gauge (G) spring-loaded core biopsy device is most commonly used for breast lesion sampling. This device features advantages such as a minimum setup requirement, low cost, and lack of spatial requirements, its disadvantages include the requirement for a unique insertion and removal of the needle for each biopsy, leading to difficulties with constant targeting and increasing procedure durations. VAB has limitations such as the requirements for an increased setup time, a dedicated assisting technologist, and space for large equipment
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