Tomosynthesis-guided vacuum-assisted breast biopsy: A feasibility study

• Published in: European radiology Vol. 26; no. 6; pp. 1582 - 1589
• Main Authors: Waldherr, Christian, Berclaz, Gilles, Altermatt, Hans Jörg, Cerny, Peter, Keller, Patrik, Dietz, Uwe, Buser, Katharina, Ciriolo, Michele, Sonnenschein, Martin Josef
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2016; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Biopsy; Biopsy, Needle - methods; Breast; Breast - diagnostic imaging; Breast - pathology; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Calcinosis - diagnostic imaging; Calcinosis - pathology; Carcinoma, Ductal, Breast - diagnostic imaging; Carcinoma, Ductal, Breast - pathology; Carcinoma, Intraductal, Noninfiltrating - diagnostic imaging; Carcinoma, Intraductal, Noninfiltrating - pathology; Carcinoma, Lobular - diagnostic imaging; Carcinoma, Lobular - pathology; Diagnostic Radiology; Ethics; Feasibility Studies; Female; Fibroadenoma - diagnostic imaging; Fibroadenoma - pathology; Fibrocystic Breast Disease - diagnostic imaging; Fibrocystic Breast Disease - pathology; Histopathology; Humans; Image-Guided Biopsy - methods; Imaging; Imaging, Three-Dimensional; Internal Medicine; Interventional Radiology; Localization; Mammography; Mammography - methods; Medical screening; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Oncology; Radiology; Ultrasonic imaging; Ultrasound; Vacuum; Switzerland; Breast cancer; Mammography; Image-guided biopsy; Diagnostic techniques and procedures; Tomosynthesis
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-015-4009-4

Purpose Evaluation of feasibility and clinical performance of a tomosynthesis-guided vacuum-assisted breast biopsy (TVAB) system compared to Stereotaxy (SVAB). Materials and methods All biopsies were performed on consecutive patients: 148 TVAB biopsies and 86 biopsies on different patients using SVAB. Evaluation criteria for each biopsy were technical feasibility, histopathology, procedure time, and complications. Results All 148 TVAB biopsies were technically successful, and gained the targeted groups of microcalcifications (100 %). In 1 of 86 SVAB procedures, it was not possible to gain the targeted microcalcifications (1 %), in 3 of 86 the needle had to be adjusted (4 %). All TVAB biopsies were performed without clinically relevant complications. Distortions were biopsied exclusively by TVAB, mean size 0.9 cm, p  < 0.0001. Of the 24 distortions, 13 were cancer, 11 Radial Scars/ CSL. The mean procedure time for TVAB was 15.4 minutes (range 7–28 min), for SVAB 23 minutes (range 11–46 min), p  < 0.0001. Conclusions TVAB is able to biopsy small architectural distortions with high accuracy. TVAB is easily feasible and appears to have the same degree of clinical performance for diagnosing microcalcifications. The increased number of biopsied distortions by TVAB is presumably due to increased use of tomosynthesis and its diagnostic potential. Key points • TVAB is easily feasible . • TVAB is able to target architectural distortions with high accuracy . • TVAB diagnoses microcalcifications with the same clinical performance as SVAB .