RSNA 2014 

Abstract Archives of the RSNA, 2014


Comparison of Prone Stereotactic vs. UprightTomosynthesis Guided Vacuum Assisted Core Breast Biopsies

Scientific Papers

Presented on December 3, 2014
Presented as part of SSM02: Breast Imaging (Biopsy Techniques)


Alexis Marie Smith DO, BA, Presenter: Nothing to Disclose
Jules Henry Sumkin DO, Abstract Co-Author: Scientific Advisory Board, Hologic, Inc
Margarita Louise Zuley MD, Abstract Co-Author: Research Grant, Hologic, Inc
Denise Chough MD, Abstract Co-Author: Nothing to Disclose
Gordon Scott Abrams MD, Abstract Co-Author: Nothing to Disclose


Digital breast tomosynthesis (DBT) is used across the country as a mammographic approach for breast screening and diagnostic workups. An attachment can be retrofitted onto an existing DBT system and used to guide core biopsy of the breast. Prone stereotactic biopsy is the current gold standard. The purpose of this study is to compare the efficiency and effectiveness of traditional prone 2D vacuum assisted core biopsy with the DBT (3D) guided upright biopsy system.


In this IRB approved study, we performed to date (11/20/ 2013 to 3/10/2014) 114 breast biopsies as part of the patients’ standard clinical care. Fifty nine were performed on the upright DBT unit and 55 on the prone stereotactic table. Data recorded for each biopsy included procedure time, type of target lesion, number of attempts to position target, number of images taken, complications, success, clip migration and subjective pain scale rating (1 – 10). Mean values were computed for each modality and compared.


The mean time was 29.1 and 32.4 minutes for the DBT guided and prone stereotactic biopsies, respectively. Calcifications constituted 87% and 99% of the targets on the DBT guided and prone biopsy units. Mean number of attempts to position the target was 1.6  for DBT guided biopsy and 2.3 for prone stereotactic biopsy. Mean values for total number of images taken was 7.6 and 10.0 for DBT and stereotactic guided biopsies. All 59 DBT guided biopsies were successful, whereas two of the prone stereotactic biopsies were not successful (aborted). Three of the patients undergoing DBT guided biopsy had a vasovagal reaction. Clip migration occurred in 11 of the DBT and 7 of the stereotactic cases. The mean subjective pain scale rating is 2.9 and 2.4 (scale 1 - 10; p>0.1) for the DBT and stereotactic biopsies, respectively.


Preliminary data show that on average, upright DBT guided biopsy is shorter in duration, has a higher success rate, takes fewer attempts to target and fewer images, hence, requiring less radiation. Clip migration occurred slightly more often with DBT guided biopsy. There is no significant difference in pain level between the two approaches.


DBT guided biopsy is an acceptable approach that is as good as or better than conventional prone stereotactic biopsy in several respects.

Cite This Abstract

Smith, A, Sumkin, J, Zuley, M, Chough, D, Abrams, G, Comparison of Prone Stereotactic vs. UprightTomosynthesis Guided Vacuum Assisted Core Breast Biopsies.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.