Abstract

BackgroundVacuum-assisted breast biopsy (VABB) has recently been gaining more popularity as a modality to reach the final diagnosis, especially in indeterminate breast lesions, resulting in a decreased number of surgical interventions and unnecessary follow-ups.ObjectiveWhile our primary aim was to look into the outcomes of the VABB technique, our secondary aim was to assess the impact of the method on changes in patients’ management.Patients and methodsThis study was a retrospective database analysis of vacuum-assisted biopsies (VABs) carried out at our breast unit during the period between January 2011 and January 2018. All our cases were image-guided; the caliber of vacuum-assisted needles used was 8 gauge (G) and 11 G. Patient demographics, lesion characteristics, and outcomes were retrieved from patients’ notes and the hospital database.ResultsA total of 122 female patients were included in the analysis, out of whom 41.8% (51 patients) were screen-detected, and 58.1% (71 patients) were symptomatic presentations. The mean lesion size on imaging was 14.8 mm (SD: 12.6); 50% (61 patients) had stereotactic vacuum-assisted breast biopsy (SVAB), and 50% (61 patients) had ultrasound-guided vacuum-assisted breast biopsy (US-VAB). Post-procedure histology was upgraded in 19.6% (24 patients), downgraded in 18.8% (23 patients), and remained unchanged in 61.4% (75 patients).ConclusionVABB is a safe and efficient procedure for the diagnosis and management of indeterminate and suspicious breast lesions. It provides an adequate amount of tissue, which can help in upgrading or downgrading histopathologically diagnosed patients, thereby decreasing the need for surgery.

Highlights

  • In 1989, Parker started performing percutaneous biopsies, using a core needle and an automatic deployment device

  • While our primary aim was to look into the outcomes of the Vacuum-assisted breast biopsy (VABB) technique, our secondary aim was to assess the impact of the method on changes in patients’ management

  • VABB was proven to be an excellent alternative to surgical biopsy, and it came to be associated with high diagnostic accuracy and low patient discomfort [3]

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Summary

Introduction

In 1989, Parker started performing percutaneous biopsies, using a core needle and an automatic deployment device. In 1995, Mark Retchard, a medical device engineer, and Fred Burbank, a radiologist, developed the technique of vacuum-assisted breast biopsy (VABB) to overcome the shortcomings of core biopsies and improve the accuracy of biopsies of microcalcification (MCC) in adipose breast tissue by using an automatic biopsy gun [1,2]. Given that larger tissue samples are obtained by VABB, and the histological diagnosis is more accurate, the role of the vacuum-assisted biopsy (VAB) was extended to therapeutic procedures [4]. Vacuum-assisted breast biopsy (VABB) has recently been gaining more popularity as a modality to reach the final diagnosis, especially in indeterminate breast lesions, resulting in a decreased number of surgical interventions and unnecessary follow-ups

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