Study population
We reviewed our database of all stereotactically (n=1204) and sonographically (n=978) vacuum assisted biopsy procedures performed in our hospital between January 2002 and December 2010.
We included in the study 53 lesions (52 patients) biopsied under stereotactic (n=43) and sonographic (n=10) VAB guidance in which LN (ALH and LCIS) was the most advanced lesion at pathologic examination.
All 53 lesions underwent surgical excision (n=33) or a minimum of 2 years´ imaging follow-up (n=20).
The patient´s age,
personal history of breast cancer,
clinical presentation (if the lesion was palpable),
mammographic breast composition,
type of VAB probe,
type of lesion (microcalcifications,
mass,
distortion,
asymmetry),
lesion size,
BIRADS classification,
percentage of lesion removal in case of calcifications,
histopathology results if the patient underwent surgery or imaging follow-up if not were recorded.
LN underestimation were defined as lesions yielding ALH or LCIS at VAB and carcinoma at excisional surgery (performed immediately after VAB or during the follow-up period due to changes at site of VAB).
Imaging techniques
Bilateral mammography was performed with a dedicated film-screen mammographic equipment (Senix 800 T; GE Healthcare,
Milwaukee,
USA) from January 2002 to February 2005 and with a FFDM unit (Senographe 2000D,
GE) from March 2005 to December 2010,
with magnification views obtained in all cases of microcalcifications.
Ultrasonography was performed using three different sonographic equipments
(Siemens Sonoline Prima,
Germany; Technos, Esaote,
Italy and MyLab 70XV,
Esaote,
Italy)
with a high-frequency linear-array transducer.
Biopsy
All VAB were obtained under stereotactic guidance (Fischer stereotactic table) using the 11G Mammotome® Vacuum Biopsy System (Ethicon Endosurgery,
Johnson & Johnson).
Specimen radiographs were routinely obtained in case of calcifications and a clip marker was deployed at the site of biopsy in cases of complete removal of the lesion.
Regular mammogram after each stereotactically guided biopsy was also performed (Fig.1).
VAB performed under sonographic guidance were performed using either 12G (n=1),
11G (n=7),
and 8G (n=2) probes (Mammotome® system and ATEC®,
Suros Surgical Systems) (Fig.2).