Accuracy and complication rates of US-guided vacuum-assisted core breast biopsy: initial results

To determine the accuracy and complications of vacuum-assisted core breast biopsy performed with ultrasonographic (US) guidance.

US-guided, vacuum-assisted breast biopsy with an 11-gauge device was performed in 71 lesions in 67 consecutive women (age range, 23-82 years; mean age, 52.9 years). Vacuum-assisted core biopsy findings were compared with excisional biopsy, mammographic follow-up, and clinical follow-up findings (follow-up, 1-19 months; mean, 9.2 months). Procedural complications and treatment were noted.

Of 71 lesions, 18 (25%) were diagnosed as malignant at core biopsy; one (1%), as premalignant; 30 (42%), as specific benign; and 22 (31%), as nonspecific benign. Of 18 malignant diagnoses, one (6%) was benign at excision. The premalignant specimen was benign at excision. Of 52 benign findings, 51 (98%) were proved benign at excision, mammographic follow-up, or clinical follow-up. One benign finding was carcinoma at excision. In this case, the specimen did not include the carcinoma because of a technical problem recognized at the time of the percutaneous procedure. Five (7%) of 71 biopsies resulted in bleeding beyond 10 minutes. One (1%) patient experienced a vasovagal response.

According to these data, US-guided vacuum-assisted core breast biopsy is accurate. There may be a slightly higher risk of bleeding, which may be related to the lack of breast compression during the procedure, when compared with biopsy performed with stereotactic guidance.