Sonographically-guided vacuum-assisted biopsy with digital mammography-guided skin marking of suspicious breast microcalcifications: comparison of outcomes with stereotactic biopsy in Asian women.
Author(s): Hahn SY, Shin JH, Han BK, Ko EY
Publication: Acta Radiol, 2011, Vol. 52, Page 29-34
PubMed ID: 21498322 PubMed Review Paper? No
Purpose of Paper
This paper compared diagnostic accuracy of ultrasound-guided vacuum-assisted biopsy (USVAB) with digital mammography-guided skin marking (DM) and stereotactic-guided vacuum-assisted biopsy (SVAB) of non-palpable microcalcified breast lesions.
Conclusion of Paper
Although SVAB had a slightly higher rate of false negatives and underestimation of high-risk and DCIS lesions than USVAB with DM, the differences between the methods were not significant.
Studies
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Study Purpose
This study compared the false negative and underestimation rates of USVAB with DM to SVAB of non-palpable microcalcified breast lesions. A total of 263 lesions with microcalcification from 261 Asian patients were biopsied using either USVAB with DM (73 lesions) or by SVAB (190 lesions). Biopsies were performed by one of nine radiologists using 11-gauge probes. For all patients, a core containing five or more flecks of calcium or at least three calcium containing cores were considered. Diagnosis of malignant, high risk, or suspicious lesions was confirmed by surgical excision and diagnosis of benign lesions was based on 12 months of follow-up and imaging.
Summary of Findings:
Of the 73 lesions biopsied by USVAB with DM, 16 were not visible by ultrasound (US), 28 were visible by US, and 29 were visible by US only after DM. Only 14 of the 140 lesions biopsied by SVAB with associated US data were visible by US. A comparable number of cores were available in specimens biopsied by USVAB and SVAB (16.7 versus 19.5, p=0.0798) and both methods produced cores containing calcium in almost all biopsies (97.9% of SVAB biopsies and 95.9% of USVAB biopsies). The false negative rate of SVAB was 17.6% and the false negative rate for USVAB with DM was 9.5%. While high-risk lesions and DCI were underestimated in lesions biopsied by SVAB (2/8 and 2/37, respectively), high-risk lesions were underestimated in only one or two lesions biopsied by USVAB with DM and no occurrences of DCIS were underestimated. However, the differences in underestimation rates were not significant.
Biospecimens
Preservative Types
- Formalin
Diagnoses:
- Neoplastic - Carcinoma
- Neoplastic - Benign
Platform:
Analyte Technology Platform Morphology X-ray Morphology Light microscopy Morphology H-and-E microscopy Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Method of tissue acquisition Sterotactic-guided biopsy
Ultrasound-guided biopsy
Preaquisition Prognostic factor US visible microcalcification
US invisible microcalcification