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Stereotactic 11-gauge vacuum-assisted breast biopsy: a validation study
Georg Pfarl1, Thomas H Helbich, Christopher C Riedl
1Department of Radiology, University of Vienna Medical School, AKH Wien, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
AJR. American Journal of Roentgenology
|November 20, 2002
Summary
Stereotactic vacuum-assisted biopsy has a 3.3% false-negative rate for cancer detection. This rate significantly decreases to 0.6% with radiologist experience, improving diagnostic accuracy.
Area of Science:
- Radiology
- Oncology
- Surgical Pathology
Background:
- Stereotactic 11-gauge vacuum-assisted biopsy (VAB) is a minimally invasive technique for tissue sampling.
- Assessing the false-negative rate (FNR) of VAB is crucial for accurate cancer diagnosis and patient management.
Purpose of the Study:
- To determine the FNR of stereotactic 11-gauge VAB in lesions subsequently treated with surgical excision.
- To evaluate factors influencing the FNR, including lesion type and operator experience.
Main Methods:
- Retrospective review of 318 lesions undergoing stereotactic 11-gauge VAB and surgical excision.
- Definition of false-negative cases: pathologically proven cancer with benign biopsy results and no atypia.
- Analysis of medical records, imaging, and histologic findings.
Main Results:
- The overall FNR for stereotactic 11-gauge VAB was 3.3% (7/214) for pathologically proven cancers.
- FNR was similar for malignant calcifications (3.5%) and malignant masses (3.0%).
- Radiologists with over 15 VAB procedures had a significantly lower FNR (0.6%) compared to those with 15 or fewer (10.0%).
Conclusions:
- Stereotactic 11-gauge VAB demonstrates a low overall FNR of 3.3%.
- Radiologist experience is a critical factor in reducing the FNR, with experienced operators achieving a 0.6% FNR.
- Failure to sample calcifications or imaging-histologic discordance were key indicators of potential false-negative findings.