Multicentre evaluation of stereotactic vacuum biopsies of mammographically indeterminate or suspicious lesions

Purpose

Vacuum biopsy (VB) promises excellent accuracy for indeterminate lesions, including microcalcifications. The purpose of this study is to check reproducibility and reliability in high quality breast centres.

Materials and method

From January 1996 to December 2000, more than 1,700 stereotactically guided vacuum biopsies (SVBs) were performed in five breast centres using a defined standard. The data shown here are based on an ongoing evaluation (presently 89% completed). Indications were ACR III 16%, ACR IVa (moderate suspicion) 63%, ACR IVb (suspicion) 63% and ACR V 5% of the cases.

Results

An additional 1.5% examinations were scheduled but not performed (lesion too close to chest wall, microcalcifications not resolved). Among performed studies the examination was terminated due to technical problems in 0.9% (90% due to one biopsy table), bleeding (0.4%), or pain (0.1%). Nine per cent of cases proved to be invasive carcinomas, 13% ductal carinoma in situ (DCIS) and 4% atypical ductal hyperplasia (ADH). In four benign lesions the pathologist recommended excisional biopsy, which confirmed the diagnoses. In the 73% benign lesions diagnostic surgery could be avoided.

Conclusion

Standardised stereotactic VB is very accurate, safe and cost effective.