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Breast Imaging |
1 From the Department of Radiology, Breast Imaging and Interventional Center, George Washington University Medical Center, 2150 Pennsylvania Ave, Washington, DC 20037 (R.F.B.); the Russell H. Morgan Department of Radiology and Radiological Science (J.M.S., A.N., O.M.B.G.); and the Departments of Oncology (S.N.G.) and Pathology (F.B.A.), Breast Imaging and Interventional Center, Johns Hopkins Medical Institutions, Baltimore, Md. Received April 7, 2000; revision requested May 26; final revision received December 18; accepted January 4, 2001. Address correspondence to R.F.B. (e-mail: radrfb@gwumc.edu).
PURPOSE: To compare the accuracy of diagnosis of invasive breast cancer with 11- and 8-gauge stereotactic vacuum-assisted biopsy (SVAB) devices and to correlate lesion diameter and accuracy of breast cancer diagnosis at SVAB.
MATERIALS AND METHODS: During a 22-month period, 489 SVAB procedures were performed with an 11-gauge probe and 305 with an 8-gauge probe. SVAB and surgical pathologic results of 104 breast carcinomas were reviewed and correlated with lesion size, number of specimens obtained, and type of SVAB probe used.
RESULTS: Four of 38 ductal carcinoma in situ (DCIS) lesions diagnosed with 11-gauge SVAB demonstrated invasion at surgery, whereas one of 23 DCIS lesions diagnosed with 8-gauge SVAB demonstrated invasion at surgery (P = .6). A mean of 12 specimens per lesion were obtained in each group. In lesions 30 mm or larger, the underestimation rate for DCIS was 43% (three of seven) with 11-gauge SVAB and 17% (one of six) with 8-gauge SVAB (P = .6). Overall, the rate of underestimation for DCIS was significantly higher in lesions 30 mm or larger (four of 13) than in smaller lesions (one of 48, P = .006).
CONCLUSION: This study demonstrated no difference in breast cancer diagnosis with the 8- and 11-gauge SVAB systems, but the accuracy of breast cancer diagnosis was greater in lesions smaller than 30 mm than in larger lesions.
Index terms: Biopsies, technology, 00.1267 • Breast, biopsy, 00.1267 • Breast, diseases, 00.71, 00.72 • Breast neoplasms, diagnosis, 00.31, 00.32
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