A prospective study of the removal rate of imaged breast lesions by an 11-gauge vacuum-assisted biopsy probe system.

BACKGROUND: More than 1,000,000 breast biopsies are performed each year as a result of abnormalities identified by imaging techniques. This prospective study was designed to determine whether complete removal of the imaged evidence of an abnormal mammogram or ultrasonogram could be achieved with percutaneous image-guided procedures using an 11-gauge vacuum-assisted biopsy probe. METHODS: Forty-five women over the age of 18 years entered the study; 50 breast lesions were identified by ultrasonography or mammography. Biopsies were obtained using an 11-gauge vacuum-assisted probe. At 6 months after biopsy, ultrasonography or mammography examinations of the biopsy site were performed. RESULTS: Forty-five lesions (90%) were completely removed. At 6 months after biopsy, 82% of the sites were lesion free. The percentage of nonrecurring lesions at 6 months after surgery was inversely related to the size of the original lesion. CONCLUSION: This device allows biopsies to be successfully combined with complete removal of the imaged lesion in a one-step minimally invasive procedure.

The revolution in breast biopsy: where is the surgeon?

Technology is now available to significantly alter the means by which breast biopsies are performed. Percutaneous image guided breast biopsies (PIGBB) are minimally invasive, accurate, and cost effective. Clinical integration of this new technology has been difficult because the procedure involves both radiology and surgical skills. Neither the majority of general surgeons nor the majority of radiologists have embraced the procedure. The technology has been available in this country for several years, but a comfortable clinical integration has not been accomplished. The surgeon, with an enhancement of existing breast imaging skills, should be able to stay involved in breast biopsy diagnosis and accommodate the new biopsy technique.

The evolution of minimally invasive breast biopsy: from FNA to percutaneous incisional and excisional biopsy.

Surgical biopsy of the breast has long been the most commonly accepted method of determining the na- ture of a clinical or mammographic abnormality. Because this method carries with it certain cost and morbidity drawbacks, physicians have investigated less invasive alternatives. Until recently, however, there has not been sufficient confidence in the minimally invasive techniques to supplant surgical breast biopsy. Fine needle aspiration (FNA) of the breast has been available for decades and, in some hands, per- formed reliably enough to avoid surgical biopsy in certain instances. For the most part, however, surgeons and other physicians have been reluctant to base definitive decision making upon the results of FNA.This is un- derstandable in that FNA carries significant insufficient tissue and false negative rates."l As a result, FNA frequently represented an additional test and attendant cost without obviating the need for surgical biopsy.

Stereotactic needle biopsy for occult breast lesions: a minimally invasive alternative.

Women are being screened with annual mammography in increasing numbers to achieve early diagnosis and improve chances of survival. A minimally invasive and cost-effective biopsy technique is needed to evaluate nonpalpable mammographically detected lesions without decreasing reliability. A technique of core biopsy with a coring needle deployed in a spring loaded gun using stereotactic localization has been developed to fulfill this need. An in-depth study of 500 consecutive stereotactic core biopsies have been analyzed and reported in this article. The study gives statistical evaluation of data and reports the breakdown of the histologic diagnosis of these cases and an analysis of detected malignancies. The study suggests that 75% of the indeterminate mammographic lesions can be judged to be benign and that no further surgery is necessary. The false negative rate is discussed in detail. The indications for stereotactic biopsy, the proper selection of patients, and the suggested follow-up are also addressed. The benign and malignant lesions are characterized in detail.