Comparison of mammographically guided breast biopsy techniques

被引:73
作者
Velanovich, V [1 ]
Lewis, FR [1 ]
Nathanson, SD [1 ]
Strand, VF [1 ]
Talpos, GB [1 ]
Bhandarkar, S [1 ]
Elkus, R [1 ]
Szymanski, W [1 ]
Ferrara, JJ [1 ]
机构
[1] Henry Ford Hosp, Div Gen Surg, Dept Surg, Detroit, MI 48202 USA
关键词
D O I
10.1097/00000658-199905000-00004
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective To determine which mammographically guided breast biopsy technique is the most efficient in making a diagnosis in women with suspicious mammograms. Summary Background Data Mammographically guided biopsy techniques include stereotactic 14-gauge core-needle biopsy (SC bx), stereotactic Ii-gauge suction-assisted core biopsy (Mammotome [Mbx]), stereotactic coring excisional biopsy (Advanced Breast Biopsy Instrument [ABBI]), and wire-localized biopsy (WL bx). Controversy exists over which technique is best. Methods All patients undergoing any one of these biopsy methods over a 15-month period were reviewed, totaling 245 SC bx, 107 Mbx, 104 ABBI, and 520 WL bx. Information obtained included technical success, pathology, discordant pathology, and need for open biopsy. Results Technical success was achieved in 94.3% of SC bx, 96.4% of Mbx, 92.5% of ABBI, and 98.7% of WL bx. The sensitivity and specificity were 87.5% and 98.6% for SC bx, 87.5% and 100% for Mbx, and 100% and 100% for ABBI. Discordant results or need for a repeat biopsy occurred in 25.7% of SC bx, 23.2% of Mbx, and 7.5% of ABBI biopsies. In 63.6% of ABBI and 50.9% of WL bx, positive margins required reexcision; of the cases with positive margins, 71.4% of ABBI and 70.4% of WL bx had residual tumor in the definitive treatment specimen. Conclusion Although sensitivities and specificities of SC bx and Mbx are good, 20% to 25% of patients will require an open biopsy because a definitive diagnosis could not be reached. This does not occur with the ABBI excisional biopsy specimen. The positive margin rates and residual tumor rates are comparable between the ABBl and WL bx. The ABBI avoids operating room and reexcision costs; therefore, in appropriately selected patients, this appears to be the most efficient method of biopsy.
引用
收藏
页码:625 / 633
页数:9
相关论文
共 28 条
[1]   SURGICAL MARGINS AFTER NEEDLE-LOCALIZATION BREAST BIOPSY [J].
ACOSTA, JA ;
GREENLEE, JA ;
GUBLER, KD ;
GOEPFERT, CJ ;
RAGLAND, JJ .
AMERICAN JOURNAL OF SURGERY, 1995, 170 (06) :643-646
[2]   Lessons from mammographic-histopathologic correlation of large-core needle breast biopsy [J].
Berg, WA ;
Hruban, RH ;
Kumar, D ;
Singh, HR ;
Brem, RF ;
Gatewood, OMB .
RADIOGRAPHICS, 1996, 16 (05) :1111-1130
[3]  
Bonzanini M, 1997, DIAGN CYTOPATHOL, V17, P353, DOI 10.1002/(SICI)1097-0339(199711)17:5<353::AID-DC8>3.0.CO
[4]  
2-B
[5]   Nondiagnostic stereotaxic core breast biopsy: Results of rebiopsy [J].
Dershaw, DD ;
Morris, EA ;
Liberman, L ;
Abramson, AF .
RADIOLOGY, 1996, 198 (02) :323-325
[6]   NONPALPABLE BREAST-LESIONS - FINDINGS OF STEREOTAXIC NEEDLE-CORE BIOPSY AND FINE-NEEDLE ASPIRATION CYTOLOGY [J].
DOWLATSHAHI, K ;
YAREMKO, ML ;
KLUSKENS, LF ;
JOKICH, PM .
RADIOLOGY, 1991, 181 (03) :745-750
[7]   SELECTIVE NONOPERATIVE MANAGEMENT OF PATIENTS REFERRED WITH ABNORMAL MAMMOGRAMS [J].
ERICKSON, EJ ;
MCGREEVY, JM ;
MUSKETT, A .
AMERICAN JOURNAL OF SURGERY, 1990, 160 (06) :659-664
[8]   Image-guided core-needle breast biopsy is an accurate technique to evaluate patients with nonpalpable imaging abnormalities [J].
Fuhrman, GM ;
Cederbom, GJ ;
Bolton, JS ;
King, TA ;
Duncan, JL ;
Champaign, JL ;
Smetherman, DH ;
Farr, GH ;
Kuske, RR ;
McKinnon, WMP .
ANNALS OF SURGERY, 1998, 227 (06) :932-937
[9]  
HASSELGREN PO, 1991, SURGERY, V110, P623
[10]   Automated detection of clustered microcalcifications on mammograms: CAD system application to MIAS database [J].
Ibrahim, N ;
Fujita, H ;
Hara, T ;
Endo, T .
PHYSICS IN MEDICINE AND BIOLOGY, 1997, 42 (12) :2577-2589