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Vacuum-assisted breast biopsies

Experience at the Antoine Lacassagne Cancer Center (Nice, France)
Published:November 02, 2005DOI:https://doi.org/10.1016/j.clinimag.2005.08.002

      Abstract

      This article presents the results of the first 318 aspiration-guided breast macrobiopsies performed using a dedicated table at the Antoine Lacassagne Cancer Center (Nice, France) between January 2001 and November 2002.
      A total of 288 procedures (90%) was performed for microcalcifications whereas that of 30 (10%) was performed for isolated opacities. There were 170 American College of Radiology (ACR) Category 4 (53.45%), 35 ACR 5 (11%), 111 ACR 3 (34.9%), and 2 ACR 2 lesions. There were 233 benign lesions that included 19 cases of atypical epithelial hyperplasia. Of the 85 malignant lesions, 33 had an invasive component. Seven of the atypical epithelial hyperplasia cases and all of the malignant lesions were managed surgically. Atypical epithelial hyperplasia was underestimated in 28.57% of the cases; ductal carcinomas in situ, in 21.15%. The positive predictive value of ACR 4 for the diagnosis of malignancy was 24.7% (42/128 cases), versus that of 12.6% for ACR 3 (14/97 cases). Among the 233 benign lesions, 128 were classified as ACR 4 and 6 as ACR 5 (all of these procedures obviated surgery).
      The advantages, drawbacks, and limitations of the technique are analyzed and indications are discussed, particularly for ACR 3 lesions.

      Keywords

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      References

        • Adrales G
        • Turk P
        • Wallace T
        • Bird R
        • Norton HJ
        • Greene F
        Is surgical excision necessary for atypical ductal hyperplasia of the breast diagnosed by Mammotome?.
        Am Surg. 2000; 180: 313-315
      1. Agence Nationale d'Accréditation et d'Evaluation en Santé. Conduite à tenir diagnostic devant une image mammographique infra-clinique anormale. ANAES. Recommandations pour la pratique clinique. Paris 1998.

        • Barreau B
        • Dilhuydy MH
        • Henriquès C
        • Gilles R
        • Valentin F
        Imagerie interventionnelle: indications, résultats et évaluation de la qualité.
        in: XXIIIemes journées Nationales de la Société Française de Sénologie et de Pathologie Mammaire. Strasbourg. 10–12 Octobre2001
        • Beck RM
        • Gotz L
        • Heywang-Kobrunner SH
        Stereotaxic vacuum core breast biopsy—experience of 560 patients.
        Swiss Surg. 2000; 6: 108-110
        • Berg WA
        • Campassi C
        • Langenberg P
        • Sexton MJ
        Breast imaging reporting and data system: inter- and intraobserver variability in feature analysis and final assessment.
        AJR Am J Roentgenol. 2000; 174: 1769-1777
        • Berg WA
        • Krebs TL
        • Campassi C
        • Magder LS
        • Sun CC
        Evaluation of 14 and 11 gauge directional, vacuum-assisted biopsy probes and 14 gauge biopsy guns in a breast parenchymal model.
        Radiology. 1997; 205: 203-208
        • Brem RF
        • Behrndt VS
        • Sanow L
        • Gatewood OM
        Atypical ductal hyperplasia: histologic underestimation of carcinoma in tissue harvested from impalpable breast lesions using II gauge stereotactically guided directional vacuum-assisted biopsy.
        AJR Am J Roentgenol. 1999; 172: 1405-1407
        • Burbank F
        Stereotactic breast biopsy: comparison of 14- and 11-gauge Mammotome probe performance and complication rates.
        Am Surg. 1997; 63: 988-995
        • Cangiarella J
        • Waisman J
        • Symmans WF
        • Gross J
        • Cohen JM
        • et al.
        Mammotome core biopsy for mammary microcalcifications.
        Cancer. 2001; 91: 173-177
        • Darling ML
        • Smith DN
        • Lester SC
        • et al.
        Malignant mammographic lesions at stereotactic vacuum-assisted biopsy.
        Radiology. 1998; 206: 711-715
        • Dilhuydy MH
        • Henriquès C
        • Barreau B
        • Palussière J
        • Joyeux P
        • Bussières E
        Biopsies chirurgicales percutanées ABBI et microbiopsies 8 gauge assistées par le vide MIBB. L'expérience multidisciplinaire du Centre de Lutte Contre le Cancer de Bordeaux.
        J Le sein. 1999; 9: 118-125
        • Feillel V
        • Lafaye C
        • Le Bouëdec G
        • et al.
        System ABBI: expérience française.
        in: 22èmes journées de la société française de sénologie et de pathologie mammaire. Toulouse, 12–14 Octobre2000
        • Geller BM
        • Barlow WE
        • Ballard-Barbash R
        • et al.
        Use of the American College of Radiology BI-RADS to repeat the mammographic evaluation of women with signs and symptoms of breast disease.
        Radiology. 2000; 222: 536-542
        • Hagay C
        • Chérel P
        • Becette V
        • Garbay JR
        Evolution des biopsies stéréotaxiques des lésions mammaires non palpables. Premiers résultats sur table dédiée numérisée avec aiguilles de 14 G.
        Gynecol Obstet. 1999; 6: 1-6
        • Heywang-Kobrunner SH
        • Schaumioffel U
        • Viehweg P
        • Hofer H
        • Buchmann J
        • Lampe D
        Minimally invasive stereotaxic vacuum core breast biopsy.
        Eur Radiol. 1998; 8: 377-385
        • Jackman RJ
        • Burbank F
        • Parker S
        • et al.
        Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted biopsy.
        Radiology. 1997; 204: 485-488
        • Jackman RJ
        • Nowels KW
        • Rodriguez J
        • et al.
        Stereotactic, automated, large-core needle biopsy of non palpable breast lesions: false-negative and histologic underestimation rates after long-term follow-up.
        Radiology. 1999; 210: 779-805
        • Jacobs TW
        • Connolly JL
        • Schnitt SJ
        Nonmalignant lesions in breast core needle biopsies.
        Am J Surg Pathol. 2002; 26: 1095-1110
        • Kerlikowske K
        Timeliness of follow-up after abnormal screening mammography.
        Breast Res Treat. 1996; 40: 53-64
        • Kim SJ
        • Morris EA
        • Liberman L
        • et al.
        Observer variability and applicability of BI-RADS terminobreast MR imaging: invasive carcinomas as focal masses.
        AJR Am J Roentgenol. 2001; 177: 551-557
        • Liberman L
        • Dershaw DD
        • Morris EA
        • Abramson AF
        • Thornton CM
        • Rosen PP
        Clip placement after stereotactic vacuum-assisted breast biopsy.
        Radiology. 1997; 205: 417-422
        • Liberman L
        • Dershaw DD
        • Rosen PP
        • Morris EA
        • Abramson AF
        • Borgen PI
        Percutaneous removal of malignant mammographic lesions at stereotactic vacuum-assisted biopsy.
        Radiology. 1998; 206: 711-715
        • Liberman L
        • Sama M
        • Susnik B
        • et al.
        Lobular carcinoma in situ at percutaneous breast biopsy: surgical biopsy finding.
        AJR Am J Roentgenol. 1999; 173: 291-299
        • Liberman L
        • Sama Michelle P
        Cost–effectiveness of stereotactic 11-gauge directional vacuum-assisted breast biopsy.
        AJR Am J Roentgenol. 2000; 175: 53-58
        • Liberman L
        Percutaneous imaging-guided core breast biopsy: state of the art at the millenium.
        AJR Am J Roentgenol. 2000; 174: 1191-1199
        • Lo JY
        • Markey MK
        • Baker JA
        • Floyd C
        Cross-institutional evaluation of BI-RADS predictive mode mammographic diagnosis of breast cancer.
        AJR Am J Roentgenol. 2002; 178: 457-463
        • Mayras C
        • Doutriaux-Dumoulin I
        Biopsie mammaire assistée par aspiration. L'expérience des CRLCC Paul Papin (Angers) et René Gauducheau (Nantes).
        Journal Le Sein. 2001; 12: 133-143
        • McKay C
        • Hart CL
        • Erbacher G
        Objectivity and accuracy of mammogram interpretation using the BI-RADS final assessment categories in 40- to 49-year-old women.
        J Am Osteopath Assoc. 2000; 100: 615-620
        • Obenauer S
        • Fisher U
        • Baum F
        • Dammert S
        • Fuzesi L
        • Grabbe E
        Stereotactic vacuum core biopsy of clustered microcalcific classified as BI-RADS 3.
        Rofo. 2001; 173: 696-701
        • Orel SG
        • Kay N
        • Reynoids C
        • Sullivan DC
        BI-RADS categorization as a predictor of malignancy.
        Radiology. 1999; 211: 845-850
        • Philpotts L
        • Shaheen N
        • Carter D
        • Lange R
        • Lee C
        Comparison of rebiopsy rates after stereotactic core needle biopsy of the breast with 11-gauge vacuum suction probe versus 14-gauge needle and automatic gun.
        AJR Am J Roentgenol. 1999; 172: 683-687
        • Reynoids H
        Core needle biopsy of challenging benign breast conditions: a comprehensive literature review.
        AJR Am J Roentgenol. 2000; 174: 1245-1250
        • Séror JY
        • Antoine M
        • Scetbon F
        • et al.
        Apport des macrobiopsies stéréotaxiques par aspiration dans la prise en charge des microcalcifications mammaires: première série prospective de 115 cas.
        Gynecol Obstet Fertil. 2000; 28: 804-819
        • Sickles EA
        Management of probably benign breast lesions.
        Radiol Clin North Am. 1995; 33: 1123-1330
        • Won B
        • Reynoids H
        • Lazaridis C
        • et al.
        Stereotactic biopsy of ductal carcinoma in situ of the breast using an 11-gauge vacuum-assisted device: persistent underestimation of disease.
        AJR Am J Roentgenol. 1999; 173: 227-229