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Benign Breast Lesions: Minimally Invasive Vacuum-assisted Biopsy with 11-Gauge Needles—Patient Acceptance and Effect on Follow-up Imaging Findings¹

¹ From the Departments of Radiology (S.H., M.W., H.C.) and Obstetrics and Gynecology (M.M.), Lainz Hospital, Wolkersbergenstrasse 1, 1130 Vienna, Austria. Received November 26, 2001; revision requested February 11, 2002; final revision received August 8; accepted August 21. Address correspondence to S.H. (e-mail: s.pankl@telering.at).

PURPOSE: To evaluate patient acceptance of stereotactic or ultrasonographically (US) guided directional vacuum-assisted 11-gauge needle biopsy of breast lesions and short- and long-term changes at mammography and US resulting from the procedure.

MATERIALS AND METHODS: For 91 benign lesions that had been sampled at either stereotactic or US-guided directional vacuum-assisted breast biopsy performed with 11-gauge needles, clinical, mammographic, and US changes were evaluated 1 week after biopsy; 6-month follow-up findings were available for 74 lesions. The subjective outcome of the procedure and patient satisfaction were assessed on the basis of a patient-completed questionnaire that incorporated a multistage scoring system. Statistical analysis of scores for condition for both biopsy methods was performed with the ² test.

RESULTS: Adverse events occurred during the procedure in four patients. Clinically visible hematomas were observed at 1-week follow-up in 79% of patients. Densities were observed on mammograms in 46% of patients 1 week after biopsy; hematomas with a maximum diameter of 2 cm were seen on sonograms in 74%. Six months after biopsy, mammography revealed discrete architectural changes in one case. No abnormalities were found at 6-month follow-up US. Fifteen patients had various complaints during the procedure; six reported feeling constrained during the first few days after biopsy, and one patient was not satisfied with the cosmetic result. No patient reported a retrospective preference for surgical biopsy instead of directional vacuum-assisted biopsy. Analysis of scores for the stereotactic and US-guided methods revealed a significant difference (P < .001) in favor of the stereotactic method for condition during biopsy, while scores for condition in the first days after biopsy were more equally distributed between the two methods (P = .386).

CONCLUSION: Directional vacuum-assisted 11-gauge needle biopsy of the breast is well accepted by patients and rarely produces changes that may alter the mammographic or sonographic appearance of the breast at 6-month follow-up.

© RSNA, 2003

Index terms: Biopsies, complications, 00.1261 • Biopsies, technology, 00.1261 • Breast, biopsy, 00.1261