Interdisciplinary Consensus Recommendations for the use of Vacuum-Assisted Breast Biopsy under Sonographic Guidance: First update 2012

M. Hahn; U. Krainick-Strobel; T. Toellner; J. Gissler; S. Kluge; E. Krapfl; U. Peisker; V. Duda; F. Degenhardt; H. P. Sinn; D. Wallwiener; I. V. Gruber; In cooperation with the Minimally Invasive Breast Intervention Study Group (AG MiMi) of the German Society of Senology (DGS); and the Study Group for Breast Ultrasonography of the German Society for Ultrasound in Medicine (DEGUM)

doi:10.1055/s-0032-1312831

Ultraschall in der Medizin - European Journal of Ultrasound, Table of Contents

Ultraschall Med 2012; 33(4): 366-371
DOI: 10.1055/s-0032-1312831

Original Article

Interdisciplinary Consensus Recommendations for the use of Vacuum-Assisted Breast Biopsy under Sonographic Guidance: First update 2012

Konsensusempfehlung zu Anwendung und Indikationen der Vakuumbiopsie der Brust unter Ultraschallsicht: erste Aktualisierung 2012

M. Hahn

¹Department of Obstetrics and Gynaecology, University Hospital Tuebingen

,

U. Krainick-Strobel

²Mammography Screening Center Tuebingen

,

T. Toellner

³Private Practice at Clinic Dr. Hancken, Stade

,

J. Gissler

⁴Vivantes – Centre of Breast Diseases Berlin

,

S. Kluge

⁴Vivantes – Centre of Breast Diseases Berlin

,

E. Krapfl

⁵Department of Obstetrics and Gynaecology, Asklepios Clinic, Langen

,

U. Peisker

⁶Hermann-Joseph-Hospital, Erkelenz

,

V. Duda

⁷Senological Diagnostic Unit, University Hospital Marburg

,

F. Degenhardt

⁸Department of Obstetrics and Gynecology, Franziskus Hospital, Bielefeld

,

H. P. Sinn

⁹Institute of Pathology, University Hospital Heidelberg

,

D. Wallwiener

¹Department of Obstetrics and Gynaecology, University Hospital Tuebingen

,

I. V. Gruber

¹Department of Obstetrics and Gynaecology, University Hospital Tuebingen

,

In cooperation with the Minimally Invasive Breast Intervention Study Group (AG MiMi) of the German Society of Senology (DGS), and the Study Group for Breast Ultrasonography of the German Society for Ultrasound in Medicine (DEGUM) › Author Affiliations

Abstract

Purpose: The vacuum biopsy of the breast under sonographic guidance (VB) was introduced in Germany in the year 2000 and the first consensus recommendations were published by Krainick-Strobel et al. in 2005. Since then, many clinical studies on this technique have been published. The purpose of this publication is to update the consensus recommendations from 2005 regarding the latest literature.

Materials and Methods: The consensus statements were the result of two preliminary meetings after the review of the latest literature by members of the Minimally Invasive Breast Intervention Study Group from the German Society of Senology. The final consensus text was review by all members of the working group. The statements listed under results obtained complete acceptance (consensus 100 %).

Results: The consensus recommendations describe the indications, investigator qualifications, technical requirements, documentation, quality assurance and follow-up intervals regarding the latest literature.

Conclusion: The VB is a safe method for extracting breast tissue for histological workup. The technique allows the resection of breast tissue up to 8 cm³. Besides the diagnostic indications, the method qualifies for a therapeutic resection of symptomatic benign lesions (e. g. fibroadenomas). The technique should be used in specialized breast centers working in a multidisciplinary setup. This paper is an expert’s recommendation for the use of VB under sonographic guidance. It is not formulated as a nationwide guideline.

Zusammenfassung

Ziel: Die Vakuumbiopsie der Brust unter sonografischer Bildgebung (VB) wurde flächendeckend in Deutschland ab dem Jahr 2000 eingesetzt. Die erste Konsensusempfehlung von Krainick-Strobel et al. erschien 2005. Seitdem ist die Literatur zu diesem Thema deutlich erweitert worden. Ziel dieser Publikation ist die Aktualisierung der Konsensusempfehlung von 2005 unter Beachtung der neuesten Literatur.

Material und Methoden: Nach Durchsicht der Literatur fand die Konsensusfindung im Rahmen von 2 Arbeitstreffen von Mitgliedern der Arbeitsgemeinschaft Minimalinvasive Mammainterventionen der Deutschen Gesellschaft für Senologie statt. Der fertige Konsensustext wurde allen Mitgliedern der Arbeitsgruppe vorgelegt. Die unter Ergebnisse genannten Punkte wurden einstimmig (Konsensus 100 %) verabschiedet.

Ergebnisse: Diese Konsensusempfehlung beschreibt die Indikationen, die Anforderungen an den Untersucher, die technischen Voraussetzungen, die Dokumentation, die Qualitätssicherung und die Kontrollintervalle unter Beachtung der aktuellen Datenlage.

Schlussfolgerung: Die VB stellt eine sichere Methode zur Histologiegewinnung bei Brusttumoren dar. Sie ermöglicht die Resektion von Gewebsvolumina bis 8 cm³. Neben den diagnostischen Indikationen eignet sich die Methode auch zur therapeutischen Exstirpation von symptomatischen, benignen Befunden (z. B. Fibroadenome). Die Technik sollte in spezialisierten, interdisziplinär arbeitenden Brustzentren durchgeführt werden. Diese Empfehlung ist als Expertenempfehlung zu verstehen und erhebt nicht den Anspruch einer Leitlinie.

Key words

breast - vacuum-assisted biopsy - ultrasound - consensus recommendations

Full Text

References

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