[Stereotactic 11-gauge directional vacuum-assisted breast biopsy: experience with 249 patients]

To assess the value of percutaneous vacuum-assisted core biopsy to improve the diagnosis of non palpable mammographic abnormalities.

A total of 252 core biopsies using an 11G Mammotome((R))were performed in 249 patients. Stereotactic localization was performed in the prone position on a dedicated digital Fischer table.

Fifty-one, or 25%, of 200 clusters of microcalcifications corresponded to carcinomas: 126 benign lesions, 23 atypical hyperplasia and LCIS, 31 DCIS, 15 invasive ductal carcinomas, and 4 false negative biopsies. In these 4 last cases, surgery was performed because radiographs of the core biopsy showed no microcalcifications; carcinoma was confirmed at histology of the surgical specimen. Using the BI-RADS system, 7 lesions were category 3, 175 lesions were category 4, and 18 lesions were category 5. From a total of 52 masses, 31 were benign lesions, 2 were borderline lesions, and 19 were invasive carcinomas. From these, 5 lesions were category 3, 31 were category 4, and 16 were category 5. Diagnostic surgical biopsy was avoided in 161 cases (63%), in 152 cases for benign lesions including 151 lesions classified as category 4 lesions and in 9 cases for multifocal or recurrent malignant lesions.

When technical pitfalls are avoided and when presence of microcalcifications in the core biopsy sample is verified, vacuum assisted core biopsy with Mammotome((R)) 11G provides accurate diagnosis of non-palpable mammographic abnormalities.