Skip to main content

Advertisement

Log in

Breast biopsy for mammographically detected nonpalpable lesions using a vacuum-assisted biopsy device (Mammotome) and upright-type stereotactic mammography unit without a digital imaging system: experience of 500 biopsies

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

The most common diagnostic procedure in the United States for mammographically detected nonpalpable lesions is a combination of a vacuum-assisted biopsy device and a prone-type biopsy table. We have used an upright-type stereotactic mammography unit without a digital imaging system instead of the prone table.

Patients and methods

Five-hundred ten biopsies of 506 mammographically detected nonpalpable breast lesions in 488 patients, consisting of 445 lesions with microcalcifications alone, 39 masses without calcifications, and 22 with both masses and microcalcifications, were attempted using a combination of a vacuum-assisted device (Mammotome) and an upright unit without a digital imaging system in a sitting position between May 1999 and February 2007.

Results

Breast tissue was obtained in 497 biopsies. Microcalcifications were confirmed radiographically in the tissue of 447 out of 459 biopsies from lesions with microcalcifications (97.4 %). One hundred thirty-seven were diagnosed as malignant, 10 as atypical ductal hyperplasia, 345 as benign, and 1 was not diagnosable. The underestimation rate was 28.0 %. Overall, 26 patients (5.1 %) had vasovagal reactions, while 19 (3.8 %) experienced mild subcutaneous bleeding. Two hundred fifty of 350 lesions, for which biopsy diagnoses were benign, were followed for a median period of 33 months. Four lesions turned out to be malignant. The false-negative rate was 2.8 %.

Conclusion

The biopsy technique using the combination of the Mammotome and an upright unit without a digital imaging system is cost-effective, safe, and accurate, and should be regarded as one of the standard biopsy methods for mammographically detected nonpalpable lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gotzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev 2006;4:CD001877.

    Google Scholar 

  2. Ohsumi S, Takashima S, Aogi K, Ishizaki M, Mandai K. Breast biopsy for mammographically detected non-palpable lesions using a vacuum-assisted biopsy device (Mammotome) and an upright-type stereotactic mammography unit. Jpn J Clin Oncol. 2001;31:527–31.

    Article  CAS  PubMed  Google Scholar 

  3. Nisbet AP, Borthwick-Clarke A, Scott N. 11-gauge vacuum assisted directional biopsy of breast calcifications, using upright stereotactic guidance. Eur J Radiol. 2000;36:144–6.

    Article  CAS  PubMed  Google Scholar 

  4. Welle GJ, Clark M, Loos S, Pauls D, Warden D, Sheffield M, et al. Stereotactic breast biopsy: recumbent biopsy using add-on upright equipment. Am J Roentogenol. 2000;175:59–63.

    Article  CAS  Google Scholar 

  5. Georgian-Smith D, D’Orsi C, Morris E, Clark CF Jr, Liberty E, Lehman CD. Stereotactic biopsy of the breast using an upright unit, a vacuum-suction needle, and a lateral arm-support system. Am J Roentogenol. 2002;178:1017–24.

    Article  Google Scholar 

  6. American College of Radiology. Illustrated breast imaging reporting and data system (BI-RADS), 3rd ed. Reston: American College of Radiology; 1998.

  7. Page DL, Anderson TJ, Roger LW. Epithelial hyperplasia. In: Page DL, Anderson TJ (eds) Diagnostic histopathology of the breast. Edinburgh: Churchill Livingstone; 1987. p. 120–56.

  8. Liberman L, Smolkin JH, Dershaw DD, Morris EA, Abramson AF, Rosen PP. Calcification retrieval at stereotactic, 11-gauge, directional, vacuum-assisted breast biopsy. Radiology. 1998;208:251–60.

    CAS  PubMed  Google Scholar 

  9. Brem RF, Behrndt VS, Sanow L, Gatewood OM. Atypical ductal hyperplasia: Histologic underestimation of carcinoma in tissue harvested from impalpable breast lesions using 11-gauge stereotactically guided directional vacuum-assisted biopsy. Am J Roentogenol. 1999;172:1405–7.

    Article  CAS  Google Scholar 

  10. Won B, Reynolds HE, Lazaridis CL, Jackson VP. Stereotactic biopsy of ductal carcinoma in situ of breast using an 11-gauge vacuum-assisted device: persistent underestimation of disease. Am J Roentogenol. 1999;173:227–9.

    Article  CAS  Google Scholar 

  11. Pfarl G, Helbich TH, Riedl CC, Wagner T, Gnant M, Rudas M, et al. Stereotactic 11-gauge vacuum-assisted breast biopsy: a validation study. Am J Roentogenol. 2002;179:1503–7.

    Article  Google Scholar 

  12. Rao A, Parker S, Ratzer E, Stephens J, Fenoglio M. Atypical ductal hyperplasia of the breast diagnosed by 11-gauge directional vacuum-assisted biopsy. Am J Surg. 2002;184:534–7.

    Article  PubMed  Google Scholar 

  13. Winchester DJ, Bernstein JR, Jeske JM, Nicholson MH, Hahn EA, Goldschmidt RA, et al. Upstaging of atypical ductal hyperplasia after vacuum-assisted 11-gauge stereotactic core needle biopsy. Arch Surg. 2003;138:619–23.

    Article  PubMed  Google Scholar 

  14. Kettritz U, Rotter K, Schreer I, Murauer M, Schulz-Wendtland R, Peter D, et al. Stereotactic vacuum-assisted breast biopsy in 2874 patients: a multicenter study. Cancer. 2004;100:245–51.

    Article  PubMed  Google Scholar 

  15. Jackman RJ, Marzoni FA Jr, Rosenberg J. False-negative diagnoses at stereotactic vacuum-assisted needle breast biopsy: long-term follow-up of 1,280 lesions and review of literature. Am J Roentogenol. 2009;192:341–51.

    Article  Google Scholar 

  16. Lai JT, Burrowes P, MacGregor JH. Diagnostic accuracy of a stereotactically guided vacuum-assisted large-core breast biopsy program in Canada. Can Assoc Radiol J. 2001;52:223–7.

    CAS  PubMed  Google Scholar 

  17. Apesteguia L, Mellado M, Saenz J, Cordero JL, Reparaz B, Miguel C. Vacuum-assisted breast biopsy on digital stereotaxic table of nonpalpable lesions non-recognisable by ultrasonography. Eur Radiol. 2002;12:638–45.

    Article  CAS  PubMed  Google Scholar 

  18. Liberman L, Kaplan JB, Morris EA, Abramson AF, Menell JH, Dershaw DD. To excise or to sample the mammographic target: what is the goal of stereotactic 11-gauge vacuum-assisted breast biopsy? Am J Roentogenol. 2002;179:679–83.

    Article  Google Scholar 

  19. Kettritz U. Stereotactic vacuum-assisted breast biopsy in 2874 patients. (reply to letter). Cancer. 2004;101:431.

    Article  Google Scholar 

  20. Wunderbaldinger P, Wolf G, Turetschek K, Helbich TH. Comparison of sitting versus prone position for stereotactic large-core breast biopsy in surgically proven lesions. Am J Roentogenol. 2002;178:1221–5.

    Article  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shozo Ohsumi.

About this article

Cite this article

Ohsumi, S., Taira, N., Takabatake, D. et al. Breast biopsy for mammographically detected nonpalpable lesions using a vacuum-assisted biopsy device (Mammotome) and upright-type stereotactic mammography unit without a digital imaging system: experience of 500 biopsies. Breast Cancer 21, 123–127 (2014). https://doi.org/10.1007/s12282-012-0360-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-012-0360-3

Keywords

Navigation