Vacuum-assisted breast biopsy: comparison of three systems

Background and objective

Stereotactic and ultrasound-guided vacuum-assisted biopsy (VAB) has an important role in assessment of screen-detected lesions, particularly suspicious microcalcification. VAB technology has rapidly developed and three systems are now being evaluated at our institution; Suros (Suros Surgical Systems, Indianapolis, IN, USA), EnCore (SENORX, Columbia, USA) and Mammotome (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA). Technical variations between these systems may impact on procedure effectiveness and patient experience. Our aim was to assess and compare these differences.

Methods

A prospective study of 60 women undergoing image-guided VAB over 4 months was performed. Four experienced radiologists used each VAB system equally. Subjective operator experience and any technical or patient complication were recorded. A patient pain questionnaire with follow-up of haematoma formation was performed.

Results

Subjective and objective parameters for the three VAB systems were tabulated, highlighting strength and weaknesses. The length of procedure varied according to the number of cores, clip placement and the particular system used. Postprocedural pain and haematoma formation also showed variation.

Conclusion

The choice of VAB equipment is dependent on operator and patient experience but should not compromise diagnostic yield. Technical features of some VAB systems may improve effectiveness for particular lesions; awareness of these variations allows safer use.