Simone Schrading MD, Presenter: Nothing to Disclose

Martina Distelmaier, Abstract Co-Author: Nothing to Disclose

Christiane Katharina Kuhl MD, Abstract Co-Author: Nothing to Disclose

Aim was to compare the clinical performance of digital-breast-tomosynthesis guided vacuum-assisted-biopsy (DBT-VAB) with that of prone stereotactic vacuum assisted biopsy using a biopsy table (PS-VAB) for histological clarification of lesions detected on full field digital mammography.  

During a one-year period, 184 patients with 191 suspicious mammographic findings were scheduled for mammography-guided vacuum biopsy. PS-VAB were performed hy using a dedicated biopsy table (Lorad Multicare) on 159 patients with 165 target lesions. Since December 2013, a system for DBT-VAB was available (Affirm, Hologic) and was used for 25 consecutive patients with 26 target lesions. Biopsies were taken with a 9G EVIVA system. We compared biopsy success rates, and time to complete biopsy.

Technical success rate was 26/26 (100%) for DBT-VAB vs. 154/165 (93%) for PS-VAB. One of the 11 lesions in which PS-VAB failed underwent successful DBT-VAB. Time to complete vacuum biopsy was 13 ± 3.5 min for DBT-VAB vs. 28 ± 10.3 min for PS-VAB (p < 0.012). Main reason for this time difference was the process of re-identifying and targeting the lesion during PS-VAB, which took 15 ± 7.6 min, versus 4 ± 2.4 min for DBT-VAB. The actual tissue sampling procedure took about the same time (13.0±6.3 min for PS-VAB vs. 9.0±3.1 min for DBT-VAB). No minor or major complications occurred during none of the interventions.

Although here, we report on our first clinical experiences with DBT-VAB, we found that this technique outperformed SP-VAB in every aspect. DBT-VAB proved easy to learn, faster to complete and allowed successful tissue sampling even of low-contrast lesions and of lesions in locations that were difficult to reach for PS-VAB. 

DBT-VAB helps avoid typical difficulties associated with PS-VAB, e.g those caused by the small biopsy window, and will likely replace PS-VAB for tissue sampling of mammographic findings.

Schrading, S, Distelmaier, M, Kuhl, C, Digital Breast Tomosynthesis (DBT) Guided Vacuum Assisted Breast Biopsy: Initial Experiences and Comparison with Prone Stereotactic Vacuum Biopsy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016976.html