Safety and Efficacy of Vacuum-Assisted Breast Biopsies under Ultrasound and Stereotactic Guidance

Palak Bhavesh Thakkar Popat; Aashna Karbhari; Nitin Shetty; Kunal Gala; Purvi Haria; Aparna Katdare; Sonal Chauhan; Vani Parmar; Nita Nair; Shalaka Joshi; Sangeeta Desai; Tanuja Shet; Asawari Patil; Ayushi Sahay; Meenakshi Thakur; Rajendra Badwe; Suyash Kulkarni

doi:10.1055/s-0043-1768040

Journal of Clinical Interventional Radiology ISVIR, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2023; 07(03): 172-178
DOI: 10.1055/s-0043-1768040

Original Article

Safety and Efficacy of Vacuum-Assisted Breast Biopsies under Ultrasound and Stereotactic Guidance

Palak Bhavesh Thakkar Popat

¹Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Aashna Karbhari

¹Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Nitin Shetty

¹Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Kunal Gala

¹Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Purvi Haria

¹Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Aparna Katdare

¹Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Sonal Chauhan

¹Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Vani Parmar

²Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Nita Nair

²Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Shalaka Joshi

²Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Sangeeta Desai

³Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Tanuja Shet

³Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Asawari Patil

³Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Ayushi Sahay

³Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Meenakshi Thakur

¹Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Rajendra Badwe

⁴Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India

,

Suyash Kulkarni

¹Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India

› Institutsangaben

Abstract

Purpose To evaluate the safety and efficacy of vacuum-assisted breast biopsy (VABB) under ultrasound and stereotactic guidance.

Methods This institutionally approved retrospective analysis comprised 60 females who underwent VABB under ultrasound and stereotactic guidance. Technical success and adverse events were analyzed as per the Society of Interventional Radiology standards. Pain score was recorded as per the visual analog scale.

Results Technical success was 100% with high specificity (100%), sensitivity (96%), negative predictive value 97%, and accuracy of 98%. Ductal carcinoma in situ underestimation rate was 4%. No major complications were encountered, and minor complication of postprocedural hematoma did not require intervention. Procedure was well tolerated with majority patients experiencing mild pain.

Conclusion VABB under ultrasound and stereotactic guidance is a safe and effective method for sampling breast abnormalities.

Keywords

breast - intervention - biopsy - vacuum-assisted biopsy

Volltext

Referenzen

References
1 Sung H, Ferlay J, Siegel RL. et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71 (03) 209-249
2 Parker SH, Jobe WE, Dennis MA. et al. US-guided automated large-core breast biopsy. Radiology 1993; 187 (02) 507-511
3 Liberman L, Feng TL, Dershaw DD, Morris EA, Abramson AF. US-guided core breast biopsy: use and cost-effectiveness. Radiology 1998; 208 (03) 717-723
4 Smith DN, Rosenfield Darling ML, Meyer JE. et al. The utility of ultrasonographically guided large-core needle biopsy: results from 500 consecutive breast biopsies. J Ultrasound Med 2001; 20 (01) 43-49
5 Fishman JE, Milikowski C, Ramsinghani R, Velasquez MV, Aviram G. US-guided core-needle biopsy of the breast: how many specimens are necessary?. Radiology 2003; 226 (03) 779-782
6 Fajardo LL, Pisano ED, Caudry DJ. et al; Radiologist Investigators of the Radiologic Diagnostic Oncology Group V. Stereotactic and sonographic large-core biopsy of nonpalpable breast lesions: results of the Radiologic Diagnostic Oncology Group V study. Acad Radiol 2004; 11 (03) 293-308
7 Jackman RJ, Nowels KW, Rodriguez-Soto J, Marzoni Jr FA, Finkelstein SI, Shepard MJ. Stereotactic, automated, large-core needle biopsy of nonpalpable breast lesions: false-negative and histologic underestimation rates after long-term follow-up. Radiology 1999; 210 (03) 799-805
8 Darling ML, Smith DN, Lester SC. et al. Atypical ductal hyperplasia and ductal carcinoma in situ as revealed by large-core needle breast biopsy: results of surgical excision. AJR Am J Roentgenol 2000; 175 (05) 1341-1346
9 Han BK, Choe YH, Ko YH, Nam SJ, Kim JH, Yang JH. Stereotactic core-needle biopsy of non-mass calcifications: outcome and accuracy at long-term follow-up. Korean J Radiol 2003; 4 (04) 217-223
10 Burbank F, Parker SH, Fogarty TJ. Stereotactic breast biopsy: improved tissue harvesting with the Mammotome. Am Surg 1996; 62 (09) 738-744
11 Berg WA, Krebs TL, Campassi C, Magder LS, Sun CC. Evaluation of 14- and 11-gauge directional, vacuum-assisted biopsy probes and 14-gauge biopsy guns in a breast parenchymal model. Radiology 1997; 205 (01) 203-208
12 Parker SH, Klaus AJ, McWey PJ. et al. Sonographically guided directional vacuum-assisted breast biopsy using a handheld device. AJR Am J Roentgenol 2001; 177 (02) 405-408
13 Yu YH, Liang C, Yuan XZ. Diagnostic value of vacuum-assisted breast biopsy for breast carcinoma: a meta-analysis and systematic review. Breast Cancer Res Treat 2010; 120 (02) 469-479
14 Penco S, Rizzo S, Bozzini AC. et al. Stereotactic vacuum-assisted breast biopsy is not a therapeutic procedure even when all mammographically found calcifications are removed: analysis of 4,086 procedures. AJR Am J Roentgenol 2010; 195 (05) 1255-1260
15 Kettritz U, Rotter K, Schreer I. et al. Stereotactic vacuum-assisted breast biopsy in 2874 patients: a multicenter study. Cancer 2004; 100 (02) 245-251
16 Tsai HY, Chao MF, Ou-Yang F. et al. Accuracy and outcomes of stereotactic vacuum-assisted breast biopsy for diagnosis and management of nonpalpable breast lesions. Kaohsiung J Med Sci 2019; 35 (10) 640-645
17 Fu SM, Wang XM, Yin CY, Song H. Effectiveness of hemostasis with Foley catheter after vacuum-assisted breast biopsy. J Thorac Dis 2015; 7 (07) 1213-1220
18 Reporting BI. Data System (BI-RADS). Reston (VA): American College of Radiology; 1998
19 Khalilzadeh O, Baerlocher MO, Shyn PB. et al. Proposal of a new adverse event classification by the Society of Interventional Radiology Standards of Practice Committee. J Vasc Interv Radiol 2017; 28 (10) 1432-1437 .e3
20 Sheth RA, Baerlocher MO, Connolly BL. et al. Society of Interventional Radiology quality improvement standards on percutaneous needle biopsy in adult and pediatric patients. Journal of vascular and interventional radiology. J Vasc Interv Radiol 2020; 31 (11) 1840-1848
21 Cassano E, Urban LA, Pizzamiglio M. et al. Ultrasound-guided vacuum-assisted core breast biopsy: experience with 406 cases. Breast Cancer Res Treat 2007; 102 (01) 103-110
22 Suh YJ, Kim MJ, Kim EK. et al. Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 8- or 11-gauge vacuum-assisted biopsy. Br J Radiol 2012; 85 (1016): e349-e356
23 Schueller G, Schueller-Weidekamm C, Helbich TH. Accuracy of ultrasound-guided, large-core needle breast biopsy. Eur Radiol 2008; 18 (09) 1761-1773
24 Ancona A, Caiffa L, Fazio V. Digital stereotactic breast microbiopsy with the mammotome: study of 122 cases [in Italian]. Radiol Med (Torino) 2001; 101 (05) 341-347
25 Brem RF, Schoonjans JM, Sanow L, Gatewood OM. Reliability of histologic diagnosis of breast cancer with stereotactic vacuum-assisted biopsy. Am Surg 2001; 67 (04) 388-392
26 Burak Jr WE, Owens KE, Tighe MB. et al. Vacuum-assisted stereotactic breast biopsy: histologic underestimation of malignant lesions. Arch Surg 2000; 135 (06) 700-703
27 Lai JT, Burrowes P, MacGregor JH. Diagnostic accuracy of a stereotaxically guided vacuum-assisted large-core breast biopsy program in Canada. Can Assoc Radiol J 2001; 52 (04) 223-227
28 Yelland A, Graham MD, Trott PA. et al. Diagnosing breast carcinoma in young women. BMJ 1991; 302 (6777): 618-620
29 Bernik SF, Troob S, Ying BL. et al. Papillary lesions of the breast diagnosed by core needle biopsy: 71 cases with surgical follow-up. Am J Surg 2009; 197 (04) 473-478
30 Burbank F. Mammographic findings after 14-gauge automated needle and 14-gauge directional, vacuum-assisted stereotactic breast biopsies. Radiology 1997; 204 (01) 153-156
31 Tseng HS, Chen YL, Chen ST. et al. The management of papillary lesion of the breast by core needle biopsy. Eur J Surg Oncol 2009; 35 (01) 21-24
32 Park HL, Hong J. Vacuum-assisted breast biopsy for breast cancer. Gland Surg 2014; 3 (02) 120-127
33 Simon JR, Kalbhen CL, Cooper RA, Flisak ME. Accuracy and complication rates of US-guided vacuum-assisted core breast biopsy: initial results. Radiology 2000; 215 (03) 694-697
34 Johnson AT, Henry-Tillman RS, Smith LF. et al. Percutaneous excisional breast biopsy. Am J Surg 2002; 184 (06) 550-554 , discussion 554
35 Bohan S, Ramli Hamid MT, Chan WY. et al. Diagnostic accuracy of tomosynthesis-guided vacuum assisted breast biopsy of ultrasound occult lesions. Sci Rep 2021; 11 (01) 129
36 Seely JM, Hill F, Peddle S, Lau J. An evaluation of patient experience during percutaneous breast biopsy. Eur Radiol 2017; 27 (11) 4804-4811