11-gauge Device Research Articles

Flat Epithelial Atypia: Comparison Between 9-Gauge and 11-Gauge Devices

BackgroundThis study aimed to establish if women with a diagnosis of flat epithelial atypia (FEA) without residual microcalcifications at stereotactic vacuum-assisted breast biopsy (VABB) could be managed with mammographic follow-up (FU) instead of surgery and to compare 9-gauge and 11-gauge devices. Patients and MethodsFrom October 2003 to January 2011, 2382 VABB procedures were performed (1373 with 11-gauge and 1009 with 9-gauge). We found 121 cases of pure FEA that were surgically treated: 57 with a 9-gauge device (group 1) and 64 with an 11-gauge device (group 2). The underestimation rate (UR) of malignancy for patients without and those with residual microcalcifications for each VABB device was calculated. Differences between groups were analyzed with the Fischer exact test. ResultsThe overall UR of FEA was 4% (2 of 57) with the 9-gauge device and 8% (5 of 64) with the 11-gauge device. With a 9-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 46), and the UR for patients with residual microcalcifications was 18% (2 of 11). With an 11-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 39), the UR for patients with residual microcalcifications at post-biopsy mammograms was 16% (5 of 25). With a 9-gauge device, 80% (46 of 57) of patients did not have residual microcalcifications after VABB. With an 11-gauge device, 60% (39 of 64) of patients had no residual microcalcifications after VABB. Differences between the 9-gauge and 11-gauge devices were statistically significant (P < .05). ConclusionWomen with FEA without residual microcalcifications after VABB can be managed conservatively. Nine-gauge VABB is associated with a lower percentage of residual microcalcifications compared with an 11-gauge device, but it is safe to follow patients with FEA if all calcifications are removed with the core biopsy.

Breast cancer diagnosis: The role of stereotactic vacuum-assisted aspiration biopsy

Aim The aim of this study is to evaluate the diagnostic accuracy and impact of the stereotactic vacuum-assisted aspiration biopsy (VAB) as a surgical treatment for non-palpable breast lesions. Methods A retrospective analysis of the diagnostic and therapeutic management of lesions having undergone VAB treatment was conducted. From February 2003 to September 2007, 525 stereotactic VABs were performed on 504 women using an 11-gauge needle device. Of these, 201 lesions were treated surgically. The concordance between VAB results and final pathology report after surgical excision was evaluated. Also examined was the impact of VAB on the quality of the surgical treatment. Results Stereotactic VABs performed with an 11-gauge device showed an underestimation rate of 23.8% for atypical ductal or lobular hyperplasia (AH). For ductal carcinoma in situ (DCIS) the underestimation rate was 31% and the underestimation rate for lobular carcinoma in situ (LCIS) was 14%. Only 38.2% of the patients with non-palpable lesions (201/525) were treated surgically and only 4% (20/504) of the patients underwent more than one surgical intervention. The VAB underestimation caused mistakes in the planning of the surgical therapy in only 9 out of 201 interventions (4.4%). Conclusions This study confirms the efficacy of the VAB procedure in the diagnosis of non-palpable breast lesions and demonstrates its usefulness in therapeutic surgical planning. VAB treatment allows for the reduction of the number of surgical procedures required to diagnose and treat non-palpable breast lesions.

Stereotactic Breast Biopsy: Comparison of Histologic Underestimation Rates with 11- and 9-Gauge Vacuum-Assisted Breast Biopsy

The purpose of this study was to compare histologic underestimations at stereotactic 11- and 9-gauge vacuum-assisted breast biopsy. The reports of 1,223 consecutive stereotactic vacuum-assisted breast biopsies were retrospectively reviewed. An 11-gauge device was used to perform 828 and a 9-gauge device to perform 395 biopsies. The pathologic results were reviewed for all cases. Biopsy results of atypical ductal hyperplasia and ductal carcinoma in situ were compared with the pathologic results after surgical excision. Underestimation was defined as the need to upgrade atypical ductal hyperplasia to ductal carcinoma in situ or invasive carcinoma at surgery and to upgrade ductal carcinoma in situ to invasive carcinoma. Statistical significance was determined with the chi-square test and 95% CI. In the 11-gauge group, 12 (26%) of 46 cases of atypical ductal hyperplasia were upgraded to ductal carcinoma in situ and one (2%) of the cases to invasive carcinoma. In the 9-gauge group, six (22%) of 27 cases of atypical ductal hyperplasia were upgraded to ductal carcinoma in situ and two (7%) of the cases to invasive carcinoma. In the 11-gauge group, 35 (28.7%) of 122 cases of ductal carcinoma in situ were upgraded to invasive carcinoma. In the 9-gauge group, 10 (23%) of 44 cases of ductal carcinoma in situ were upgraded to invasive carcinoma. There was no statistically significant difference between 11-gauge biopsy and 9-gauge biopsy in underestimation of atypical ductal hyperplasia and ductal carcinoma in situ.

Clipmarkierung nach MRT-gesteuerter Vakuumbiopsie der Mamma

The purpose of our study was to determine the placement accuracy, usefulness as a guide for wire localization, and long-term stability of tissue marker clips following MR-guided vacuum-assisted biopsy (VB) of breast lesions. During a 2-year period, MR-guided VB with an 11-gauge device was performed in 79 lesions. In 26 lesions a marker clip was placed at the biopsy site. In 18 cases, the clip was shown to be closely adjacent to the lesion on post-interventional MR images. In seven cases in which minor bleeding occurred, the clip dislocated (< or =15 mm) in the direction of the needle pathway. In one case dislocation in the dorsal direction (< or =5 mm) was observed. In eight cases with a malignant or borderline histology according to the VB, the marker clips served as targets for mammographically guided wire localization. In all of those patients, histology results derived from open surgery confirmed those of VB. Eighteen patients with benign findings according to the VB were followed up 6 months later. Among these cases we found a significant displacement of the marker clip in one case (3 cm). The clip generally caused a round artifact (diameter of 9+/-2 mm). In two cases it was not possible to determine whether the lesion had been removed completely or was just behind the artifact caused by the clip. Based on our results, clip marker placement following MR-guided vacuum biopsy should be called into question due to the possibility of masking the lesion by a metallic artifact and because of possible dislocation.