VABB has permitted a higher quality and quantity material obtained for its analysis, as well as advantages acquired without the necessity of performing reinsertions of the needle.
Using VABB the histological underestimation is lower than with the core biopsy system (6), having a 98% sensitivity and a specificity near to 100% (7).
DBT is a method which provides a greater quantity of breast information, overcoming the difficulties in the visualization of images that with the 2D could not be observed because of the morphology of the breast tissue and the method limitation (structures superposition), especially in images with architectural distortions and asymmetries. Whereas with DBT, in our experience, it provided its highest potential.
The quality of DBT with the advantages of VABB, allows visualization of the target to be very precise. This procedure is also highly tolerated, having no severe complications. (8)
Moreover, the utilization of this methodology has provided us the possibility to carry out a better evaluation of the breast parenchyma without overlapping tissue. (9) This was evident in one of the cases which had an ipsilateral finding, and in this way, the therapeutic approach has been modified. In another patient, we could confirm bilateral lesions.
For tomo only lesions, we have found a greater number of invasive carcinomas, similar to other studies. This was reported in architectural distortions and asymmetries. These lesions resulted to have a lower histological grade, a minor growth rate, and a better prognosis compared to lesions detected with 2D FFDM. (10, 11)
In cases that had microcalcifications, we could not find significant potential differences using DBT, because of 2D FFDM with magnification views
About the radiant doses, they are between the adequate range permitted for a percutaneous practice.
This procedure requires a fewer number of x-ray expositions, decreasing its duration and the radiant dose.
Entities with a higher diagnostic incident were precursor lesions and invasive carcinoma, especially in architectural distortions which tended to be malignant, similar to other publications (4, 5, 9).
It was also observed that some tomo only lesion cases corresponded to ipsilateral findings not visible in 2D FFDM. DBT ended up increasing the sensibility in the detection of ipsilateral and contralateral lesions (5).
In our series of tomo only lesions the sensitivity was 100 % for architectural distortions and 43 % in asymmetries. (5,9)
DBT provides us the opportunity to identify lesions which resulted to be false negative in 2D FFDM, increasing the specificity of the diagnosis, as well as accelerating its detection. It also diminishes the necessity to carry out other complementary studies, reducing sanitary costs.