Shambhavi Venkataraman MD, Presenter: Nothing to Disclose

Vandana Mukesh Dialani MD, Abstract Co-Author: Nothing to Disclose

Valerie Joan Fein-Zachary MD, Abstract Co-Author: Nothing to Disclose

Tejas S. Mehta MD, Abstract Co-Author: Nothing to Disclose

To determine if using an 8 gauge vacuum assisted device for stereotactic core breast biopsy improves diagnostic accuracy over an 11 gauge device.

A retrospective analysis was done on all patients referred to our department for stereotactic core biopsy of non- palpable, BIRADS 4 and 5 lesions, between January 2005 and September 2006. Biopsy was performed using either an 8 or 11 gauge (G) vacuum assisted mammotome device on a horizontal Lorad table. Using an IRB approved protocol, medical records, imaging studies and pathology were reviewed. The pathology on the core biopsy was categorized as: 1-Benign, 2- ‘Atypia’ {including lobular neoplasia (LN), flat cell atypia (FCA), and atypical ductal hyperplasia (ADH)}, 3- Ductal carcinoma in situ (DCIS) and 4- Invasive carcinoma (IC). An upgrade was defined as an increase in category number of core pathology compared to surgical pathology.

Of the 198 core biopsies, 104 (52.5%) were with an 8G and 94 (47.5%) with an 11G needle. 185 were for calcifications and 13 for masses. The pathology on the core biopsy was benign in 110 and non-benign in 88 (ADH n=24; FCA n=6; LN n=4; DCIS n=36; IC n=18). Excision was recommended and data on surgical pathology was available on 83 non-benign core biopsies. In addition, 1 benign biopsy also had surgical excision due to an ipsilateral breast cancer. Of these 84 biopsies (83 non-benign and 1 benign), 44 were performed with 8G (52.4 %) and 40 with 11G (47.6 %) needle. There were 4 upgrades with 8G (9.1 %) and 9 upgrades with 11G (22.5%) needle. There were no major complications with the core biopsies in any of our patients.

In our series, the use of an 8G needle increased the accuracy of diagnosis by over 90%.

We found that diagnostic accuracy is superior with an 8G vacuum assisted core biopsy device compared to an 11G device.

Venkataraman, S, Dialani, V, Fein-Zachary, V, Mehta, T, Stereotactic Breast Biopsy: Is an 8 Gauge Needle Superior to an 11 Gauge Needle for Diagnostic Accuracy?.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011672.html