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A comparison of diagnostic performance of vacuum-assisted biopsy and core needle biopsy for breast microcalcification: a systematic review and meta-analysis

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Abstract

Background

Core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are both popularly used breast percutaneous biopsies. Both of them have become reliable alternatives to open surgical biopsy (OSB) for breast microcalcification (BM).

Aims

It is controversial that which biopsy method is more accurate and safer for BM. Hence, we conducted this meta-analysis to compare the diagnostic performance between CNB and VAB for BM, aiming to find out the better method.

Methods

Articles according with including and excluding criteria were collected from the databases, PubMed, Embase, and the Cochrane Library. Preset outcomes were abstracted and pooled to find out the potential advantages in CNB or VAB.

Results

Seven studies were identified and entered final meta-analysis from initially found 138 studies. The rate of ductal carcinoma in situ (DCIS) underestimation was significantly lower in VAB than CNB group [risk ratio (RR) = 1.83, 95% confidence interval (CI) 1.40 to 2.40, p < 0.001]. The microcalcification retrieval rate was significantly higher in VAB than CNB group (RR = 0.89, 95% CI 0.81 to 0.98, p = 0.02), while CNB owned a significantly lower complication rate than VAB (RR = 0.18, 95% CI 0.03 to 0.93, p = 0.04). The atypical ductal hyperplasia (ADH) underestimation rates were not compared for the limited number of studies reporting this outcome.

Conclusions

Compared with CNB, VAB shows better diagnostic performance in DCIS underestimation rate and microcalcification retrieval rate. However, CNB shows a significantly lower complication rate. More studies are needed to verify these findings.

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Funding

This study was supported by grants from the Health and Family Planning Commission of Hebei Province (No.20150362) and the Key Research Project of Medical Science of Hebei Province (No.20160194).

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Authors and Affiliations

  1. Department of Thyroid and Breast Surgery, Jiangsu Taizhou People’s Hospital, Taizhou, China

    Xu Chen Huang

  2. The Second Department of General Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, No. 12 Jiankang Road, Shijiazhuang, China

    Xu Chen Huang, Xu Hua Hu, Xiao Ran Wang, Chao Xi Zhou, Fei Fei Wang & Gui Ying Wang

  3. Department of Breast Center, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, No. 12 Jiankang Road, Shijiazhuang, China

    Shan Yang

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  1. Xu Chen Huang
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  2. Xu Hua Hu
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Correspondence to Shan Yang or Gui Ying Wang.

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Huang, X.C., Hu, X.H., Wang, X.R. et al. A comparison of diagnostic performance of vacuum-assisted biopsy and core needle biopsy for breast microcalcification: a systematic review and meta-analysis. Ir J Med Sci 187, 999–1008 (2018). https://doi.org/10.1007/s11845-018-1781-6

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