Vacuum biopsy in the UK

The first vacuum-assisted core biopsy (VACB) apparatus in the UK was installed for clinical use with stereotactic guidance at King's College Hospital in 1998. Since then it has been incorporated into routine clinical practice for the assessment of non-palpable mammographic abnormalities, particularly microcalcification and areas of architectural distortion not visible on ultrasound examination, and more than 150 VACB procedures are carried out per year. There are now more than 50 VACB units in use in the UK.

The potential advantages of VACB over standard 14G core biopsy are:

• 1. Larger samples obtained

• 2. No repeat insertion of the needle necessary

• 3. Haematoma evacuated during the procedure

• 4. More tissue available for histological examination

• 5. Sampling effective when probe positioned several millimetres away from the lesion

• 6. Improved calcium retrieval rates, particularly from small clusters of indeterminate microcalcification

• 7. Fewer equivocal (B3, B4) results

• 8. Improved sensitivity for detection of invasive carcinoma in an area of ductal carcinoma in situ

• 9. Marker clip deployment when mammographic marker is removed.

The results of published studies together with data from the UK trial of 14G core biopsy versus 11G mammotome will be discussed, and a strategy for future development of the use of VACB in diagnostic and assessment centres in the UK will be suggested.